共1页/11条首页上一页1下一页尾页
回复:11 阅读:2431
72 year old with a large thigh mass

stevenshen 离线

帖子:343
粉蓝豆:2
经验:343
注册时间:2008-06-03
加关注  |  发消息
楼主 发表于 2009-10-17 07:50|举报|关注(0)
浏览排序[ 顺序 逆序 楼主 支持 精彩 ]  快捷回复
姓    名: ××× 性别:  72 年龄:  male
标本名称: Thigh mass (9 cm)
简要病史:  
肉眼检查: Homogeneous fleshy mass with focal cystic change

Frozen section interpretation and diagnosis?

Have difficulties to upload the photomicrograph..will try another time...

  • 72 year old with a large thigh mass图1
    图1
  • 72 year old with a large thigh mass图2
    图2
  • 72 year old with a large thigh mass图3
    图3
  • 72 year old with a large thigh mass图4
    图4
标签:
本帖最后由 于 2009-10-31 06:19:00 编辑
0
×参考诊断
Solitary fibrous tumor

海上明月 离线

帖子:9476
粉蓝豆:1172
经验:10007
注册时间:2009-08-29
加关注  |  发消息
1 楼    发表于2009-10-18 12:08:00举报|引用
返回顶部 | 快捷回复
 请上传图片。谢谢!
0
回复
signature
王军臣

stevenshen 离线

帖子:343
粉蓝豆:2
经验:343
注册时间:2008-06-03
加关注  |  发消息
2 楼    发表于2009-11-14 07:09:00举报|引用
返回顶部 | 快捷回复

Pictures posted successfully!

What's the appropriate frozen section diagnosis?

What's your best guess?

0
回复

mjma 离线

帖子:703
粉蓝豆:24
经验:789
注册时间:2006-09-28
加关注  |  发消息
3 楼    发表于2009-11-14 08:53:00举报|引用
返回顶部 | 快捷回复
Hemangiopericytoma or malignant solitary fibrous tumor, probably low grade, but careful mitotic count is needed for this determination. 
0
回复
signature

聞道有先後,術業有專攻

pathseeker 离线

帖子:20
粉蓝豆:1
经验:20
注册时间:2009-11-17
加关注  |  发消息
4 楼    发表于2009-11-17 15:37:00举报|引用
返回顶部 | 快捷回复

 试着说说

首先考虑为恶性间叶组织肿瘤。

倾向恶性神经鞘瘤、恶性SFT、纤维肉瘤,需免疫组化鉴别。

0
回复

兵马俑 离线

帖子:150
粉蓝豆:2
经验:152
注册时间:2009-06-05
加关注  |  发消息
5 楼    发表于2009-11-22 14:21:00举报|引用
返回顶部 | 快捷回复
以下是引用pathseeker在2009-11-17 15:37:00的发言:

 试着说说

首先考虑为恶性间叶组织肿瘤。

倾向恶性神经鞘瘤、恶性SFT、纤维肉瘤,需免疫组化鉴别。

0
回复
signature
轻松工作,快乐生活

stevenshen 离线

帖子:343
粉蓝豆:2
经验:343
注册时间:2008-06-03
加关注  |  发消息
6 楼    发表于2009-11-24 08:44:00举报|引用
返回顶部 | 快捷回复

Dr. Ma is right on the money. Can we ask you to comment about how you come to the conclusion? What are the most helpful features for you in this case? Thanks a lot.

0
回复

浯水清 离线

帖子:12
粉蓝豆:1
经验:12
注册时间:2009-11-24
加关注  |  发消息
7 楼    发表于2009-11-24 10:04:00举报|引用
返回顶部 | 快捷回复
 胶原组织在里面, 还有图四有局部的HPC样血管。
0
回复

3673566 离线

帖子:1879
粉蓝豆:79
经验:3305
注册时间:2006-10-29
加关注  |  发消息
8 楼    发表于2009-11-24 10:47:00举报|引用
返回顶部 | 快捷回复
以下是引用mjma在2009-11-14 8:53:00的发言:

Hemangiopericytoma or malignant solitary fibrous tumor, probably low grade, but careful mitotic count is needed for this determination. 

除此之外,是否还需要排除滑膜肉瘤?

需要做免疫组化鉴别:CD34,CK7,CK19,BCL-2,CD99,EMA,VIM,S-1OO,DES,等.

0
回复

mjma 离线

帖子:703
粉蓝豆:24
经验:789
注册时间:2006-09-28
加关注  |  发消息
9 楼    发表于2009-11-24 12:11:00举报|引用
返回顶部 | 快捷回复
My impression based on the FS photomicrographs was made boldly with a hunch and aided by the excellent FS quality. In real practice I would have been more cautious. The high cellularity of the neoplasm, a vague storiform growth pattern, vacuolated cytoplasm seen at least focally, thick collagenous fibers, and many collapsed small vessels (capillaries). While all of these are consistent with a few types of soft tissue neoplasm, I was most impressed by the last high power photo of FS - it looks just like the hemangiopericytoma I am familiar with. The anatomic location and patient's old age should bring out a few differential diagnoses with such a hypercellular spindle cell neoplasm. Others aside, I will say that cells in sarcomatoid synovial sarcoma and malignant peripheral nerve sheath tumor usually are more uniform in the nuclear size and shape (elongated or oval) and more intersecting and fascicular in architecture. Cells in hemangiopericytomas have moderately pleomorphic nuclear size and shape, and they can display storiform growth and clear cells focally. Immunohistochemical confirmation on permanent sections is needed without exception.
0
回复
signature

聞道有先後,術業有專攻

yourself 离线

帖子:663
粉蓝豆:7132
经验:691
注册时间:2007-06-30
加关注  |  发消息
10 楼    发表于2009-11-28 10:05:00举报|引用
返回顶部 | 快捷回复
 冰冻切片报告间叶源性恶性肿瘤就可以,诊断与鉴别诊断待常规石蜡切片及免疫组化。
0
回复

stevenshen 离线

帖子:343
粉蓝豆:2
经验:343
注册时间:2008-06-03
加关注  |  发消息
11 楼    发表于2009-11-30 09:00:00举报|引用
返回顶部 | 快捷回复
  • Although there are not many responses, but all the discussion are to the point.
  • For this particular case,  I think 冰冻切片报告间叶源性肿瘤 will be sufficient, unless one can absolutely sure about the diagnosis. It will be dangerous to make a incorrect diagnosis that lead to unneccesary radical surgery. One has to be cautious to make a definite "benign" or malignant diagnosis.
  • Frozen diagnosis: cellular spindle cell neoplasm
  • Final diagnosis: solitary fibrous tumor (CD34 diffusely and strongly positive)
  • Thanks to Dr. Ma for the excellent comments!
0
回复
回复:11 阅读:2431
共1页/11条首页上一页1下一页尾页
【免责声明】讨论内容仅作学术交流之用,不作为诊疗依据,由此而引起的法律问题作者及本站不承担任何责任。
快速回复
进入高级回复
您最多可输入10000个汉字,按 "Ctrl" + "Enter" 直接发送
搜索回复/乘电梯 ×
按内容
按会员
乘电梯
合作伙伴
友情链接