报癌还是要慎重 我不敢报 炎症较重

Yes, I do believe this is a case of invasive squamous cell carcinoma of uterine cervix. Although the histologic sections suffered some cautery and other artefacts with suboptimal orientation (excuse my criticism, not against you as the pathologist), making assessment of tangential cut of surface difficult, I think the shapes of the rare nests embedded in desmoplastic stroma and cytologic atypia seen are convincing enough. The depth of invasion, however, is difficult to evaluate.

 Invasive squamous cell carcinoma.

很多时候鳞癌伴很重炎症反应，不能因疬（没找到正确的字，sorry)废食。左最下图有细胞间桥（intercellular bridges)， 是鳞状细胞的特征。有时不好区别鳞细胞，腺细胞时有帮助。本例可能有血管淋巴侵润 (lymphovascular invawion)，好好找找。

mjma老师意见：我认为此例是宫颈浸润性鳞癌了。从片子上看，此标本人为假象太多，比如烧灼、包埋方向等都有问题，因此判断起来有困难。（请原谅我的直接，从病理角度出发，对事不对人而已）。我认为那几个在间质中的细胞巣以及细胞学的非典型性已经足够诊断了。至于浸润深度从所给图片就很难判断了。

顺便提一下，mingfuyu老师说的应该是因噎废食的“噎”字吧？

 CIN,再检

 宫颈浸润性鳞癌

 宫颈浸润性鳞癌

 明显浸润了，鳞癌。

 宫颈浸润性鳞癌

 是

  宫颈浸润性鳞癌

 鳞癌

 CIN   再活检证实

 鳞癌

以下是引用杨斌在2009-7-11 0:27:00的发言：  I agree with Drs. Ma and Yu. This is an invasive SCC. It is fragmented which generates challenge in this case. Heavy inflammation should not detour your diagnosis of cancer. Actually I share the concern with Dr. Mingfu Yu that you should carefully to examine if there is lymphovascular invasion in this case. One thing I suggest you can confirm your diagnosis is to call the clinician to ask if she or he saw a cervical mass or ulcer uncer colposcopy.

试译:我同意马医生和喻医生的意见.这是一个浸润性鳞癌.它是一个碎片故此给本例带来挑战.重度炎症不会改变我的癌的诊断.事实上我和喻明芙医生一样关注本例是否有淋巴血管的浸润.我建议的一件事是:你打电话给临床医生问一下他/她是否看见宫颈肿块或溃疡在阴道镜上,这样你可以证实你的诊断.

 I agree with Drs. Ma and Yu. This is an invasive SCC. It is fragmented which generates challenge in this case. Heavy inflammation should not detour your diagnosis of cancer. Actually I share the concern with Dr. Mingfu Yu that you should carefully to examine if there is lymphovascular invasion in this case. One thing I suggest you can confirm your diagnosis is to call the clinician to ask if she or he saw a cervical mass or ulcer uncer colposcopy.

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