谢谢两位老师的精彩分析，最初我们考虑的是：转移癌？生殖细胞性肿瘤？等，免疫组化结果所有上皮性标记及胚胎性标记均阴性，GFAP可疑阳性，NSE和CgA散在阳性，Vim强阳性。

仔细观察，某些区域瘤细胞弥漫排列，浸润于小脑皮质，淋巴瘤是否还不能排除？

补充病史：患者有6年血糖升高病史，据手术医师介绍术中病灶呈囊性，其内可见似脓性囊液。

每天上传免疫组化并加做一些标记，敬请各位前辈分析指导，谢谢！

 Germ cell tumor，maybe mixed Germinoma and Yolk Sac Tumor

试译mjma老师帖子：

 这是一例恶性肿瘤，局灶坏死，浸润周围小脑皮质（图10－11）。这些图片不能清楚显示肿瘤细胞是否有上皮分化，有的图细胞胞浆空泡状，但是并没有其它特殊的提示。65岁女患者小脑实质肿瘤，转移比原发恶性肿瘤更常见，但其浸润性生长方式又不支持常见的乳腺及肺源的转移癌。HE图片不排除原发的髓母细胞瘤。所以需要免疫组化分型，建议以下标记：AE1, Cam5.2, S100, synaptophysin, NSE, CD56 (or CD57) 和 GFAP，期待结果。

This is a focally necrotic malignant neoplasm with infiltration into the surrounding cerebellar cortical parenchyma (figures 10-11). From these photos it is not clear to me whether the malignant cells have clearcut epithelial differentiation. Some of them display vacuolated cytoplasm, but little indication of any specific direction of differentiation could be detected. In a 65-year-old woman, metastases are more common than primary malignancies in the cerebellar parenchyma, but the infiltrative growth pattern argues against the more commonly seen metastatic carcinomas of mammary or pulmonary origin. Primary medulloblastoma cannot be ruled out by HE stain. Therefore, this case requires immunohistochemical classification. I suggest the following markers - AE1, Cam5.2, S100, synaptophysin, NSE, CD56 (or CD57) and GFAP - and look forward to any follow-up.