腺癌

 乳头状腺癌

 腺癌

 腺癌

 细支气管肺泡癌

    细支气管肺泡癌

 支持

以下是引用swsu8796在2010-7-15 12:19:00的发言：  支持

细支气管肺泡癌

 肺泡状结构不明确，应为浸润性癌，即乳头状腺癌

 细支气管肺泡癌

 细支气管肺泡癌

 腺癌

 腺癌

Although the architecture and cytology are both very suggestive, the diagnosis of bronchioloalveolar carcinoma cannot be made on a small specimen like this bronchoscopic biopsy (or fine needle aspiration/biopsy specimens) because by definition BAC has no stromal invasion and one can only tell this after histologic examination of the entire lesion (resected). Therefore the recommended diagnosis for such case is "adenocarcinoma (see comment)." And in the comment describe this possibility. Having seen many lung invasive adenocarcinoma with a BAC component makes me very reluctant to even suggest BAC based on small biopsies like this. More importantly is to perhaps check for KRAS mutations in malignant cells in this biopsy.

    细支气管肺泡癌

   腺癌

 非常赞成马老师意见。肺癌的异质性比其他器官癌的异型性要大得多，因此活检标本一般不轻易诊断细支气管肺泡癌。从仅有的图片看，形态也不是很支持细支气管肺泡细胞癌。报告为腺癌比较好。