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- B2264锥切标本发现的...够癌吗？（已会诊）
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| 姓 名： | ××× | 性别： | 女 | 年龄： | 33 |
| 标本名称： | CINⅢ | ||||
| 简要病史： | |||||
| 肉眼检查： | 锥切宫颈，未见明显肿块 | ||||
切缘处间质内多点可见腺管样结构浸润
免疫组化：CK7（+++）、CK20（—）、ER（—）、PR（—）、CerbB-2（—）、胶原Ⅳ（—）、SMA（—，周围的平滑肌组织+）、Ki67<5%
会诊单位1：符合中肾管腺癌。建议到专科单位2进一步会诊。
会诊单位2：目前恶性证据欠充分。建议进一步检查除外中肾管腺癌。
会诊单位3：符合中肾管增生。
标签：宫颈 中肾管
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本帖最后由 于 2010-02-28 21:47:00 编辑
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×参考诊断
（宫颈）中肾管增生（有多种会诊意见，详见第1楼）
There are four types of lesions about cervical methonephric tubules.
1. Mesonephric reminants: In the felly sectioned cervix in up to 22% women. incidently finding. A few benign tubules aggregates with or without duct.
2. Mesopnephric hyperplasia: Mesonephric reminants may be proliferative. It is almost always found incidently. There are three types of hyperplasia: lobular, diffuse, and ductal (called ductal hyperplasia). Lobular mesonephric hyperplasia in the most common, accounting about 80% of the cases. Lobular clusters of tubules with eosinophilic lumen secretion surround mesonephric duct. Diffuse pattern may be mistaken as carcinoma. The cells may have mild atypia.
3. Atypical mesonephric hyperplasia. Architecture and cells show marked atypia. Rare
4. Mesonephric carcinoma.
There is no any atypia above cases. It is a classic mesonephoric hyperplasia. It is totally benign.
Stains: PAS positive for secretion.
Tubules are positive for CD10 and p16 (cytoplasmic, not nuclear)
Differential dx: other carcinomas: especially adenoma malignum and clear cell ca.
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