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形态学难以诊断的卵巢类癌

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楼主 发表于 2009-09-12 02:56|举报|关注(1)
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57 y AA women/L ov mass 8x6x4 cm. This is the AFIP case in Jan 1974. Dr. Henry J Nosrr was Chair of Gynecology/breast Department at AFIP. He and his colleques reviewed the case, and also sent the case to MGH for second oppinion. The case was reviewed by Dr. Robert E. Scully and Dr. Stanley J. Robboy. I found the case in 2004 for immunostain research of ovarian sex cord stroma tumors and noticed their original interpretation for this case.Remember that there were no immuno atains in 1974. They had different oppinion and no final conclusion about this case.

I would like to share this case with our Chinese pathologists.

1. Know how difficult for some cases if there is no immunostain

2. To learn the concept of these world leading pathologists.

3. Hope our patholgoists know these greast pathologists. Welcome some ones to write some brief introduction for these pathologists,Robert E. Scully, Henry J Nosrr, Stanley J. Robboy. All of them are alive

4. Try yourself and you may have a better diagnosis than these experts. Ha, ha.

cz

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本帖最后由 于 2010-06-09 23:19:00 编辑
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1 楼    发表于2009-09-12 10:19:00举报|引用
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 excellent slides!

Sex cord tumor with annular tubules should be considered first.

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duoduoxi..
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随舞飞扬 离线

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2 楼    发表于2010-07-18 23:40:00举报|引用
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 老师们啊,你们说英语多了我看着就像看天书了,别笑我,我不是懒,我想看明白了再看其他的文章,可是一直不是很明白。
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3 楼    发表于2010-03-09 11:52:00举报|引用
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 性索-间质肿瘤如sertoli-leydig 细胞瘤,颗粒细胞瘤要考虑,其次是类癌要考虑。
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4 楼    发表于2011-03-06 21:38:00举报|引用
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 漂亮的图片,精彩的分析,谢谢赵老师金老师!
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121 楼    发表于2014-11-18 05:20:22举报|引用
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 像支持细胞瘤

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maiwei42..
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大家好,我来也。

cqzhao 离线

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6 楼    发表于2009-11-03 03:34:00举报|引用
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本帖最后由 于 2009-11-03 03:36:00 编辑  

Dr. Norris: Final Long  Letter to Contributor pathologist (March. 21, 1974).( I copied parts to you)

-In talking to these fellows at a meeting last week, I took the position that the lesion might be a carcinoid, and they got rather upset. They hold their view strongly the lesion is a SCT.

-I think we should keep the diagnosis open and see if we definitely resolve with time whether or not the lesion is a SCT or carcinoid

 

cz: 

At that time, Dr. Norris though mostly it was an carcinoid case. However most pathologists in the gynecologic department at AFIP were agaist him.

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7 楼    发表于2009-10-24 10:33:00举报|引用
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 支持细胞瘤。
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方寸见世界,镜下定乾坤。

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8 楼    发表于2009-09-12 02:59:00举报|引用
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 I cannot paste photos and will try later. Sorry. cz
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9 楼    发表于2009-10-07 11:33:00举报|引用
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 猜一个:卵巢Wolff管肿瘤
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10 楼    发表于2009-09-12 07:50:00举报|引用
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 There are more than 10 slides for this tumor. Most areas of the tumor look like first three photos, and focal areas like photos 4 and 5 (low and high power). So above photos represent the entire tumor. Now you can guess the diagnosis or have differential diagnosis. Your performance may be better than Drs. Scully, Norris or Robboy.

I will tell you their interpretation in 1974 after you have your oppinion. In the end I will show you the IHC results I did in 2005 (30 years later).

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11 楼    发表于2009-10-16 11:34:00举报|引用
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 This cases is here for a long time. Thank above interpretaion.

Dr. Norris at AFIP signed the case originally in January 14, 1974. His differential diagnosis included sertoli cell tumor (SCT) and carcinoid, but he favorred carcinoid. He had a long discussion in his report. Also the case was discussed in department conference.

Dr. Norris is an excellent gyn/breast pathologist and worked for about 30 years in gyn/breast department  at AFIP and was the Chair of the department for many years(longest chair in the department). He did a lot of important research in the areas of gyn/breast pathology. Dr. Kurman once worked at AFIP and was Dr. Norris's staff pathologist for a few years in the late 1970th. In the early 1990 he retired from AFIP and Worked in a group in Florida. Tavassoli became the Chair after Dr. Norris retired from AFIP. Now Dr. Norris completely retired and enjoys his life in Florida.

Do you agree with Dr. Norris's interpretation for this case?

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12 楼    发表于2009-09-12 18:39:00举报|引用
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 我瞎猜

1.性索间质肿瘤:支持细胞瘤或环小管性索瘤

2.卵巢子宫内膜样癌有时也会表现出性索样结构

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13 楼    发表于2009-09-12 18:57:00举报|引用
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 哈哈,都试一试谁比世界顶级专家厉害!

形态很善良,良性或低度恶性。乱猜了:类癌。其实如果能选2个,第二个是支持细胞瘤。

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14 楼    发表于2009-09-12 19:06:00举报|引用
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 倾向支持细胞肿瘤
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15 楼    发表于2009-09-12 22:13:00举报|引用
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 倾向支持细胞瘤。
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16 楼    发表于2009-09-13 11:54:00举报|引用
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 血管多,我会考虑类癌的。
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17 楼    发表于2009-09-14 22:59:00举报|引用
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 支持细胞瘤。我遇见一例跟本例形态基本相同。
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18 楼    发表于2009-09-14 23:44:00举报|引用
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 Dr. Henry J Nosrr , Dr. Robert E. Scully and Dr. Stanley J. Robboy.

我知道一些,他们都是顶级妇科病理专家,尤其崇敬Scully

我基本同意fangg:环状小管性索肿瘤。

但是Dr.zhao说了,主要结构是前三张图,那么修正一下诊断:Sertoli细胞瘤,部分伴有环状小管结构。

鉴别诊断如Dr.Young以前的一篇经典文献中所述,在此从略。

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19 楼    发表于2009-09-20 06:17:00举报|引用
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以下是引用wfbjwt在2009-9-13 12:06:00的发言:

 我能感觉赵老师的意思,如果按形态诊断,多半都要错了,楼下的猜得越离谱越可能就对了。呵呵

You are smart person, but you may be wrong this time. ha, ha.
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20 楼    发表于2009-11-03 03:31:00举报|引用
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本帖最后由 于 2009-11-03 03:37:00 编辑         Dr. Stanley J. Robboy (carcinoid expert) currently is at Duke and is the president of CAP from this month for one year.

He was at MGH at that time. He reviewed the case and wrote the report:

 

I have looked at the seven EM photos and believe that the granules differ from those in carcinoid.

 

 

cz:

Basically he did not think it was carcinoid.

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