这个小孩不简单，长大可以当个好医生。

 所列大体组织图象还不错，镜下图象不清晰。从大体看首先还要象炎性假瘤。能否再发一些清晰的图象，等待！

 大体图片象肿瘤

 这个标本第一刀是临床手术医生切的,所以我们就只能顺着它的切口下去,大体看确实有点像肿瘤,但镜下病变的区域主要是地图样的坏死,怎么看也不像肿瘤,可这坏死又是怎么来得呢?我百思不解,请各位老师帮我支招。谢谢啦！

 再传一些照片，关注中

 今天得知该患儿去年曾不小心摔伤过一次，摔伤后没上医院在家躺了好几天（可怜的孩子父母在外打工，家里只有爷孙俩），后来慢慢恢复。有了这个重要的病史，我又把片子找出来看，周围确实有出血，但没有含铁血黄素沉着，可以解释吗？

 This is a very interesting case. The pictures are not very clear. However, from the pictures we can see it is a solid tumor with irregular shaped pink vascular proliferation. There are numerous mildly dilated vascular spaces lined by bland-looking plump cells. My differential diagnosis includes littoral cell angioma, hemangioendothelialoma or others. I am favor the first. Immunohistochemical study will be very helpful. Littoral cell angioma will be positive for CD31, CD34, CD68 and lysozyme, occasionally also positive for S-100. For the hemangioendothelialoma, the only positive markers are the vascular markers, CD31, CD34 and factor 8. 

 谢谢候军老师！结合临床病史及镜下改变，我更倾向炎性假瘤哦，但我一定照您说的去做一些标记看看吧。