以下是引用xljin8在2010-5-1 11:55:00的发言:
非常有意思的病例,诊断确实比较困难。根据形态学,鉴别诊断要考虑: 1)内膜样腺纤维瘤; 2)支持-间质细胞肿瘤; 3)具有性索间质分化的高分化内膜样癌; 4)苗勒氏管腺纤维瘤; 5)其它;
本病例主要问题是年龄轻、治疗不彻底,要考虑保存生育功能和进一步治疗等问题。 诊断良性有些不放心,因为细胞有轻-中度异型性和组织坏死。因此更倾向诊断交界性内膜样腺纤维瘤(Endometrioid adenofibroma, Borderline malignancy)。当然最后诊断前,必须多取材和IHC标记。
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Agree the differential dx.
Most likely it is a borderline endometrioid tumor (endometrioid tumor with low maligant potential).
If you are not sure, order some stains (EMA, inhibin).
Epithelial tumor: positive for EMA, negative for inhibin.
Sex cord tumor: negative for EMA, positive for inhibin.
This case shows typical features of endometrioid tumor-glandular structures with squamous metaplasia).
Ovarian endometrioid borderline tumor is relative rare.
Some times it is difficult to distinguish benign from borderline endometrioid tumors.
Borderline tumors show the features similar to uterine endometrial complex hyperplasia.
以下是引用xljin8在2010-5-1 11:55:00的发言:
非常有意思的病例,诊断确实比较困难。根据形态学,鉴别诊断要考虑: 1)内膜样腺纤维瘤; 2)支持-间质细胞肿瘤; 3)具有性索间质分化的高分化内膜样癌; 4)苗勒氏管腺纤维瘤; 5)其它;
本病例主要问题是年龄轻、治疗不彻底,要考虑保存生育功能和进一步治疗等问题。 诊断良性有些不放心,因为细胞有轻-中度异型性和组织坏死。因此更倾向诊断交界性内膜样腺纤维瘤(Endometrioid adenofibroma, Borderline malignancy)。当然最后诊断前,必须多取材和IHC标记。
|
Agree the differential dx.
Most likely it is a borderline endometrioid tumor (endometrioid tumor with low maligant potential).
If you are not sure, order some stains (EMA, inhibin).
Epithelial tumor: positive for EMA, negative for inhibin.
Sex cord tumor: negative for EMA, positive for inhibin.
This case shows typical features of endometrioid tumor-glandular structures with squamous metaplasia).
Ovarian endometrioid borderline tumor is relative rare.
Some times it is difficult to distinguish benign from borderline endometrioid tumors.
Borderline tumors show the features similar to uterine endometrial complex hyperplasia.