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I think this is a mucinous cystic neoplasm based on your photos. The rule of thumb for diagnosis of any mucinous neoplasm of the ovary is not to make diagnosis based on few fields or few slides. There are some basic pathologic information missing from this case before I can even provide any opinion to it.
Is it unilateral or bilateral?
Is there solid area in the cyst?
Is there peudomyxoma peritoneii or not?
How about the surface of the tumor, smooth and glistenning or with focal irregular areas on surface?
How many sections you take from this 9.0 cm cystic tumor (you should take minimal 9 sections!)?
Is there convincing evidence of stromal invasion from any of the slides you have?
After review all your slides, please show us some low power photos of the worst areas that concerns you. Then we can discuss from there if this is a primary or secondary tumor, if it is a benign, borderline or malignant neoplasm. Again, the point is to using this case to make our thinking process more logic and reasonable, not to BET on the diagnosis with limited views and photos.
I think this is a mucinous cystic neoplasm based on your photos. The rule of thumb for diagnosis of any mucinous neoplasm of the ovary is not to make diagnosis based on few fields or few slides. There are some basic pathologic information missing from this case before I can even provide any opinion to it. Is it unilateral or bilateral? Is there solid area in the cyst? Is there peudomyxoma peritoneii or not? How about the surface of the tumor, smooth and glistenning or with focal irregular areas on surface? How many sections you take from this 9.0 cm cystic tumor (you should take minimal 9 sections!)? Is there convincing evidence of stromal invasion from any of the slides you have?
从你给出的图片我判断这是一个粘液性囊性肿瘤,经验的法则是:我们不能从很少的几张切片和几个区域得出卵巢粘液性肿瘤的诊断。这个病例缺失了基本的病理信息,以至于我不能得出任何肯定的诊断。 这个肿瘤是单侧的还是双侧的? 这个肿瘤是实性的还是囊性的? 是否有腹膜的假粘液瘤? 肿瘤的表面如何?光滑的还是有局部的不规则区域? 对于这个9cm的肿瘤你取材了几块组织?(你最少应该取9块) 在所有的切片中,你是否发现确切的间质浸润的证据? 在复习完你所有的切片后,请给我们提供几张你看来最严重的区域的低倍镜图片!这样我们就能够来讨论了,这是第一种肿瘤?还是第二种?这是良性肿瘤?交界性?还是恶性?需要再强调一次的是,我的观点是用这个例子让我们的思路更加的合理和有条理,而不是仅仅依靠几张图片来打赌和猜测! |
zhang197510 离线