倾向于鳞状细胞癌。在胸水中，腺癌占到80%以上，鳞癌还不到5%，所以在胸水中见到癌细胞，归入腺癌正确的几率很高。

该例仔细观察，细胞没有腺癌常见的球团状结构，细胞之间更趋向于平铺，细胞核无明显的偏位，而是较为居中，胞浆较为实性，这些都是鳞状细胞癌的特点，所以倾向于鳞状细胞癌。

 Read above argument about adeno or squamous ca. Some times it is difficult to tell squamous ca from adenocarcinoma in cytology. However it is very easy by using IHC.

For this case if we can rule out mesothelial origin (calretinin negative), then we know it is a cancer case.

Next step we need to figure out the possible origin, including squamous vs adeno.  How? We need IHC stains

P63, ck5/6 for squamous ca, mucicarmin stain for adenocarcinoma

CK7/ck20

TTF1

Of cause we need to have clinial correlation with imaging results

腺癌

腺癌