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- B1776Rosai-Dorfman Disease present in breast (cqz 16)
| 以下是引用cqzhao在2009-4-16 13:12:00的发言：
You are great. RD is rare in breast. I saw three breast cases for one year when I was at AFIP. In fact i work in Magee women's hospital (about 30,000 surgical cases with half for breast and half for gyn) for three years and we do not have any breast RD case. AFIP is a consulting institute and this is why there are many rare and difficult cases.
Dr. 笃行者 can tell us why you think it is RD in your first impression? Also please have a brrief summary about RD, clinical, morphologic, IHC, treatment, prognosis et al. Thank, cz |
还是请Dr.zhao在您方便的时侯给大家讲一讲有关RDD的诊断和治疗原则。
不过，既然Dr.zhao提问为什么该例首先想到RDD，只好做简要回答：
低倍镜下，1、有丰富而淡染胞浆的大细胞（组织细胞样细胞）组成的淡染区域，与由淋巴细胞、浆细胞等组成的深染区域相间分布；2、淋巴样细胞相对呈小簇状分布，提供了诊断线索，使我想到本病。一旦想到本病，则可在高倍镜下发现，许多淋巴样细胞其实是在大的组织细胞样细胞的胞浆范围内，也就是说淋巴细胞在组织细胞的胞浆内，亦即伸入（或吞噬）现象，而这一现象是具有特征性的。所以我有八九成把握考虑RDD。当然要确诊还需免疫组化（如S-100、CD68等）支持，以及排除其他诸如组织细胞等肿瘤。说实话淋巴瘤没有在我的考虑范围内，因为低倍镜下形态不像。
- 博学之，审问之，慎思之，明辨之，笃行之。
还是请Dr.zhao在您方便的时侯给大家讲一讲有关RDD的诊断和治疗原则。
笃行者 ,
I am gynecologic/breast pathologist and cytopathologist, do not read other surgical specimens. This is my previous AFIP case. Frequently speaking I needed to review the text book before I pasted the case here. So I am not qualified to talk RD in more details. sorry. cz
