临床：粘液性囊腺瘤

 谢谢，曹大夫，同意性索样肿瘤，但是Sertoli-leydig cell tumor何以出现这样的有突起的滤泡样结构呢？如果考虑幼年型颗粒细胞瘤的话，基本可以解释图像的结构，但切片中又似乎可见少量带红包浆的Leydig 细胞

 幼年型颗粒细胞不会有索状结构，Sertoli-leydig cell tumor也可以有滤泡样结构的。

Sertoli-leydig cell tumor是人体中组织学最复杂的肿瘤，Leydig 细胞可以很少量。

 Another very interesting case. I cannot believe you provide two challenge and unusual cases the same day!  I basically share the differential diagnoses with Dr. Cao, but with different emphasis. Although I cannot see cytology very well, I am highly suspicious for a "juvenile granulosa cell tumor with focal lutinization", rather than a true Sertoli-Leydig cell tumor. Immunostaining with inhibin and EMA should be able to sort them out. Thanks for sharing with us!

 性索间质肿瘤，Sertoli-leydig 细胞瘤可能性大。

非常有趣的病例。临床诊断为囊腺瘤， 大体标本有囊壁样结构，能否提供囊壁的照片？谢谢！