I favor a dx of atypical hemagioma. Patient should have completely excision biopsy. Clinical-imaging follow-up. The reasons are similar to the case cqz-20. I have a lot of discussion in this link.

http://www.ipathology.cn/forum/forum_display.asp?keyno=158702

 最近有时会想一个问题，美国的朋友打电话有时也討论此问题： 在美国工作紧张，压力大， 是否有价值，有效果，花费许多时间和精力在华夏网站上。

Difficult to type Chinese.

Many people here just saw the photos and then gave a dx. Just wonder what you can get in this way.

In fact there are too many expert pathologists in China. They have more responsibility to teach young pathologists in the local hospitals. They have the responsibility to develop the pathology in China. It is easy for them to do these issues. I know there are relative numbers of American Chinese pathologists whoactively paticipate the discussion and lectures in this web. Many Chinese expert pathologists gave lecture in this web. However, how many Chinese expert pathologists attend actively the case discussion? Some chinese pathologists told me that Chinese expert pathologists or professors are very busy for daily work, for book, for meeting talk. Seem that we in the US are not busy. 无语.

 对不起Dr. zhao，我首先接受您的批评。首先我要检讨，我做的就不好。

我想，可能是中国文化造成的这种现象。您知道，在国内的课堂上很少有人向老师提问题。在国内讲课也很少有人与教授讨论问题。并不是我们的学习积极性不够高。我个人就是个例子：“敏于行而讷于言”，总感觉不如别人，我所知道的可能别人都知道了，别人知道的我却不知道。

国内同行看贴的多，回帖的少，可能有下列情况：一是看不懂不敢说；二是拿不准不好意思说，怕说错；三是都想听听别人怎么说，看看别人的意见，只是喜欢向别人学习。再说国内大多数基层医院，病理医生手底下可以参考的资料实在是太少了，很难参加讨论。

以后一定改正！

也希望广大网友多多发表意见。

Dr. Ivgq:

乳腺内：血管肉瘤

You mean that it is bengin if it is located under the skin. 

Can you show us the reference?

Thanks,

cz

 又处于良性/交界性/高分化血管肿瘤之间的尴尬境地。

如果定性困难，不妨考虑临床处理有何不同？血管肉瘤要求切除乳房，交界性只要切除肿块并随访。

我猜测，本例比Dr.cqzhao的case 20似乎病变更严重一些（细胞密度高，核深染并有不典型性，有吻合的血管腔），至少为不典型血管病变吧。

也许Ki67有帮助？