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- 1例右侧乳晕下囊性包块FNAC(T1013)
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病史摘要：
女性患者王X 30岁
主诉：无意间发现右侧乳晕下一包块.
外科情况：右侧乳晕下可扪及一3.0X3.0大小的包块，边界清，活动度尚好。
B超:发现右侧乳晕下可见一29mmX28mm液性暗区，边界清晰。
临床诊断：右侧乳腺囊肿
常规消毒下行细针吸取穿刺，抽吸出约7毫升淡咖啡色液体。全部离心，取试管底部沉淀物常规涂片、制片。HEX5
女性患者王X 30岁
主诉：无意间发现右侧乳晕下一包块.
外科情况：右侧乳晕下可扪及一3.0X3.0大小的包块，边界清，活动度尚好。
B超:发现右侧乳晕下可见一29mmX28mm液性暗区，边界清晰。
临床诊断：右侧乳腺囊肿
常规消毒下行细针吸取穿刺，抽吸出约7毫升淡咖啡色液体。全部离心，取试管底部沉淀物常规涂片、制片。HEX5
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本帖最后由 于 2010-05-28 21:29:00 编辑
- 三十功名尘与土，八千里路云与月。
×参考诊断
Interesting case and thank for sharing.
I once did a lot of breast FNA when I was cytofellow at USC where all breast mass lesions would be referred to cytopathologists to do FNA. Now days FNA is rare to be used for the primary evaluation of breast lesions at Magee and most large medical centers in the US. If we do not consider the money, cost-effect, it will be easy for pathologists to read breast core bx than FNA.
For this case I woud like to sign out:
-Negative for maligancy.
-clusters of apocine cells.
-Suggestive of fibrocystic changes.
Comment:
Mostly it is a lesion with cystic papillary apocine metaplasia even though the papillary lesion cannot be completely excluded.
FNA combined with clinical impression and imaging finding (Triple test) is highly accurate. If one of the parameters is discordant, surgical biopsy is warranted. Benign Triple test should return for follow up in 3 to 6 months. (write this part in your comment for all FNA breast cases to protect yourself).
In fact 3 cm cystic lesion should be excisioned. Of cause I will not write this sentence in my report. Pathologists do not need to take all the responsblity for patient care. We take care of the part we should have.
| 以下是引用cqzhao在2010-5-29 0:54:00的发言：
Interesting case and thank for sharing. I once did a lot of breast FNA when I was cytofellow at USC where all breast mass lesions would be referred to cytopathologists to do FNA. Now days FNA is rare to be used for the primary evaluation of breast lesions at Magee and most large medical centers in the US. If we do not consider the money, cost-effect, it will be easy for pathologists to read breast core bx than FNA. For this case I woud like to sign out: -Negative for maligancy. -clusters of apocine cells. -Suggestive of fibrocystic changes. Comment: Mostly it is a lesion with cystic papillary apocine metaplasia even though the papillary lesion cannot be completely excluded. FNA combined with clinical impression and imaging finding (Triple test) is highly accurate. If one of the parameters is discordant, surgical biopsy is warranted. Benign Triple test should return for follow up in 3 to 6 months. (write this part in your comment for all FNA breast cases to protect yourself).
In fact 3 cm cystic lesion should be excisioned. Of cause I will not write this sentence in my report. Pathologists do not need to take all the responsblity for patient care. We take care of the part we should have. |
非常感谢赵老师的指导！学习了！我已转或将转您的诊断意见到其他两个专业网非妇科细胞学会诊栏目相发帖里，让大家一起学习、分享。
- 三十功名尘与土，八千里路云与月。
