| 图片： | |
|---|---|
| 名称： | |
| 描述： | |
- B1803少见乳腺肿物，鉴别诊断？ (cqz-18, 5-7-2009)
图1
图2
| 姓 名： | ××× | 性别： | 年龄： | ||
| 标本名称： | |||||
| 简要病史： | |||||
| 肉眼检查： | |||||
about 60 y/f, right breast mass 2 cm by imaging, breast core biopsy.
1. Your differential diagnosis?
2. What will you do next?
Please do not just give a diagnosis. Your dx is a guess dx even though your diagnosis may be right.
As pathologists we should learn how to analyse our cases with logic thought.We should have differential dx for all cases in our mind even for the easy cases. We can use available sources (such as IHC, molecular methods, history, consultation) to rule in or rule out the differential dx, then make the final dx.
Learning the priniciple for diagnosis is much more important than learning a few cases.
标签：乳腺化生性癌 叶状肿瘤 平滑肌肉瘤 肉瘤 鉴别 ck7 VIM
-
本帖最后由 于 2009-05-07 18:28:00 编辑
相关帖子
×参考诊断
Leiomyosarcoma of the breast（乳腺平滑肌肉瘤）
| 以下是引用zrj711在2009-5-7 19:44:00的发言：  化生性癌吗?需要更多证据低倍图呢! |
如果我遇到这样的病例，我的第一印象是：梭形细胞化生性癌---可以用CK7、CK8/18等确定其上皮性质；周围可能有原位癌成分；另外，梭形细胞癌也常标记肌上皮标记物（如P63、S-100、calponin等故需注意与肌上皮癌鉴别）。
当然一定要有其他鉴别诊断：1、恶性叶状肿瘤---寻找良性上皮成分；梭形细胞CK阴性而Vimentin阳性；或可有异源性分化（如骨、肌源性分化等）。2、乳腺间质肉瘤。3、乳腺非特异性软组织肉瘤。……
期待Dr.zhao的结果与分析。
- 博学之，审问之，慎思之，明辨之，笃行之。
-
lfl001200546 离线
- 帖子：2808
- 粉蓝豆：40
- 经验：2808
- 注册时间：2007-02-14
- 加关注 | 发消息
-
本帖最后由 于 2009-05-10 21:39:00 编辑
笃(du)行者 ：“反复看，查文献，多取材，做特免，实在不行请外援”。Very good. I think I will not forget the word "笃".
This case was a breast core biopsy, only one tissue block. The photo represents the lesion in the available specimen.
More IHC results: ER, PR, Her2 negative.
Will you sing out the case (?diagnosis) or do more study? If you want to work more on this case, what will you do? What immunostains will you order? Why? You can order the immunostains. I am your lab technologists and do the stains for you and tell your the stain results.
I am in Los Angeles to enjoy my vocation time. Glad to work for this case with your guys.
cz
