来点高倍啊

 最后一张图发镜了

 造釉细胞性牙龈瘤

 peripheral adamantoblastoma

 图8是外耳道肿块的图1，对吧。

 造釉细胞瘤与腺样囊性癌鉴别。

请来点高倍的图片。

 考虑腺样囊性癌

 adenoid cystic carcinoma,but peripheric adamantoblastoma must be excluded.

 腺样囊性癌

 这真是没办法诊断。多形性低度恶性腺癌，基底细胞腺癌等皆有可能

鉴别诊断主要考虑1）腺样囊性癌，2）低度恶性多形性腺癌，3）基底细胞样鳞状细胞癌。提供的HE照片不够清楚，组织学鉴别可参考下表：我倾向诊断低度恶性多形性腺癌。
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	基底细胞腺癌	腺样囊性癌	低度恶性多形性腺癌	基底细胞样鳞癌
核分裂＞3/10 HPF 细胞核成角 周边细胞栅栏状 鳞状细胞分化 表面鳞状上皮内瘤变 浸润性 坏死 筛孔状结构 圆形筛孔+分层状粘液	+/- + ++ -/+ - + -/+ - -	+ ++ - - - ++    +/-（实体型）    +/-（实体型）        ++	罕见 - -/+ -/+ - ++ - ++ -	+ - ++ ++ ++ ++ ++ - -