难道是子宫内膜腺癌III级——瘤细胞呈实性片块状生长？

又像是子宫内膜间质细胞来源的，请哪位老师指点一下，谢谢！

Two cell elements/biphasic tumor: malignant glandular component and squamoid/plump spindle cell componet.

Three major differential diagnosis: Adenoacanthoma, adenosquamous carcinoma, and malignant mixed mullerian tumor(MMMT).

My impression: Adenoacanthoma, based on the low-power growth pattern and relatively bland-appearing squamoid area.  (in adenosquamous carcinoma, squamous component is malignant, while in MMMT, the spindle cell element should be more cellular with marked atypia: nuclear pleomorphism and increased mitotic figures, which are not present in this case)

原发 子宫内膜样腺癌由相似于正常宫内膜的腺体组成。

在高、低级别分级中只考虑腺体结构，鳞状分化及桑葚化生的实行细胞团不增加肿瘤分级（临床不太需要）。

20%---50%或更多的子宫内膜样癌含有不同数量的鳞状分化。

鳞状分化的标准：使用标准的染色技术证明有角化

                               有间桥

                               其中3/4条：1，成片生长没有腺体形成或栅栏结构

                                                    2，细胞界限清楚

                                                    3，浓红染细胞浆质

                                                    4，当与同一肿瘤中的其他病灶比较时其核浆比例减少。