What's your frozen section diagnosis and why?

很有意思 的一个病例。

图3能看到一些异型细胞，象是浸润脂肪；图1右下角的细胞不知道高倍下外观如何。

如果，粗针穿刺的确是浸润性小叶癌的话，应该以粗针穿刺为准，或者就等常规切片了。

另外，还有一个病需要鉴别，那就是粒细胞肉瘤。

请问，粗针穿刺后是否进行过治疗？

以前粗针穿刺已经诊断了浸润性小叶癌，现在临床要求冰冻进一步诊断还是要求判断切缘？

我的感觉它是炎症，这些小细胞没有浸润性小叶癌的排列方式。不过真正发报告很难下决心，毕竟以前诊断了浸润性小叶癌----如果是我做冰冻，浸润性小叶癌与炎症性病变无法区分，只能延迟等待常规切片。

有脂肪的组织也能切出这么好的冰冻切片，真的太牛了！

Thanks for all the response and discussion.

I hope that this case will highlight the difficulties of breast tissue frozen.

To answer Abin's question...yes, the frozen is for diagnosis and margin evaluation.

I think the most helpful photo are figure 2, 3, and 6.

I might have a few high magnification photos.

I cannot find the high power pictures.

The answer is: invasive lobular carcinoma.

From the reponses, there were almost equal numbers of "inflammatory" and "neoplastic".

I hope this case demonstrated a couple of points and hope you enjoy it.

1. It is very difficult to differentiate inflammatory cells and invasive lobular (frozen)

2. One might be able to find very subtle clues for the diagnosis by careful examination of all pictures 

3. There are single rows of tumor cells (Fig.2 and 3)

4. Very unusual for inflammatory cells to infiltrate "dense" stroma in an organized fashion (Fig. 6) 

 学习了，谢谢

没看到癌