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请关注Dr.cqzhao提供的脑膜恶性黑色素瘤病例(头痛脑脊液检查)—极其罕见

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楼主 发表于 2010-04-07 23:41|举报|关注(0)
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请网友们关注Dr.cqzhao提供的脑膜恶性黑色素瘤病例(头痛脑脊液检查)—极其罕见。

通过病例分析,使我们认识到:脑脊液检查和脑肿瘤的诊断与鉴别诊断中又多了一条思路,多了一根钥匙。

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1 楼    发表于2010-04-08 12:42:00举报|引用
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 这个病例原在脱落细胞学专栏。感谢赵老师,感谢网管老师将这个病例转到疑难罕见病例专栏,供大家学习和讨论。
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2 楼    发表于2010-04-08 12:48:00举报|引用
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 不管是细胞病理学还是组织病理学诊断,都应该对难以诊断的病例追根刨底。这是一个做病理人的基本态度。这样才能推进病理进步和提高。共勉。

请允许我引用赵老师在该例讨论中一段发言:

 cqzhao 
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  • 发表于 2010-3-30 3:18 {资料} {好友} {短信} {引用} {快回 47 楼 
        

     This is a rare and interesting case. Occasionally I came here to  check and notice no people who are truely interested to this case. I am not interested to continue to complete this case until Dr.  海上明月 asked me about this case.

    In this section, I saw a lot of cases to show some atypical cells in pleural or peritoneal fluid. Questions are these cells are reactive mesothelial cells or malignant cells. In many situation we cannot answer the questions. We must do some basic stains, such as calretinin and BerEP4. This is the principle all residents should know. If we know they are malignant cells (most common adenocarcinoma), we should try to know the origins of the adenocarcinoma and provide more information to clinicians. This is our duty.

    Do not use the terms too often, suggestive; may be; suspicious et al.


      cqzhao 
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  • 发表于 2010-3-30 3:23 {资料} {好友} {短信} {引用} {快回 48 楼 
        

     For the case I mentioned above:

    Cytopathologists asked clinician to get second time of CSF. It is a malignant melanoma based on IHC result and cytologic features (very calssic for both). Patient had no melanoma history, so it may be a primary melanoma of meninges.


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