细胞看起来有异型；可是大体标本与镜下形态结合起来看，不知道该诊断什么；一两张照片不清晰。

患者才22岁，别冒险，等石蜡切片吧。

Generally speaking pathologists should have dx for most ovarian tumors in FS.Your photos are not very good. Are there papillary structures in the cystic wall/

 所见的HE图片是冰冻的吧，可惜图片看的不是很清楚。

请尽可能传上好的图片，看到清晰的图片再说吧。

• For a young woman and from what I can see on the pictures...it would be a very tough call on frozen.
• There are old and fresh hemorrhage, bland multinucleated cells and papillae, and atypical cells.  
• Overall still favor benign entities, such as hemorrhagic corpus luteum (luteoma) or endometriosis.
• Thanks for posting the such a challenging case and I look foward to hearing the final diagnosis.

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 Photos 1-3: like benign cystic mucinous tumor.

phtos 5-8: not sure what they are. Epithelial or stromal component. pan ck, ck7, ck20, vimentinin, cd10, inhibin

photos in the fluid: like endometrial glands. It can be endosalpingiosis, endometriosis, 术中人工脱落的细胞, ,metastatic tumor (chance is low), or reactive mesothelial cells.

The key is to know the nature of the solid ares in photos 5-8 (epithelial or stromal). Then you can think about the glands in the fluid.

 Agree with Dr. Zhao.  Favor benign cystadenoma in ovary.

The cells in fluid appear benign, but don't know how the cells get there. 

还是不知道诊断什么。

薄囊壁看起来就是粘液性囊腺瘤；

囊壁切片实性部分不知道是什么？请详细描述大体标本所见，该范围位于囊内壁/外壁？范围大小？难道是附壁结节——比如，肉瘤样癌、间皮肿瘤？详细检查大标本，多取材。

腹水的切片感觉还是反应性增生的间皮，可是细胞似乎是有一些异型，但是还是认为恶性证据不足。

比较复杂的病例，制片、摄影也欠满意，还是慢慢熬吧，别急着下结论。