Your differential diagnoses and frozen section diagnosis?

很好的例子，学习了，谢谢楼主。

 楼主诊断：睾丸间质细胞瘤（Leydig cell tumor）。

楼上已有两位考虑到这个诊断了。

• The diagnosis is: Leydig cell tumor
• A couple of people have considered " 间质细胞肿瘤". Good job!
• Indeed the cytologic features are very worrisome for a malignant neoplasm on frozen.
• Has to combine with clinical, gross features, and careful microscopic examination to come with the best possible diagnosis. defer for permanent section probably is appropriate for many frozen cases - if a defintive diagnosis can not be rendered.  

Sorry I don't have any more photomicrographs from the frozen slides. But I can assure you that these three pictures do represent what it is look like on frozen sections.

I agree that this case is difficult to interpret...some of the choices I saw are pretty good.

1. Germ cell tumor (seminoma or embryonal carcinoma)

2. DLBCL

3. Leydig cell tumor

4. Metastatic (carcinoma, melanoma)

It's time to make your guess and tell us why.

Will announce the anwer next week!

请多传些照片

间质细胞肿瘤也要考虑。

间质细胞肿瘤也要考虑。

 图片很漂亮！睾丸恶性肿瘤，主要是精原细胞瘤与DLBCL鉴别。精原细胞瘤常见一些，DBCL少见。

本例肿物周围残存曲细精管，细胞大，边界不清，浆丰富，红染，核大，核仁红、明显。间质少量炎细胞浸润。肿物内有无残存曲细精管，间质淋巴细胞浸润情况，有无合体样细胞，免疫组化PLAP、LCA等，对鉴别有帮助。

暂时倾向DLBCL。期待常规病理。