男，76，肝硬化，腹水。

图1-4是细胞块，5-CK18，6-CK8，7-MC，8-CR，9-Kp-1。

液基制片里感觉没什么可疑细胞。

 大量组织细胞和少量间皮细胞。

血性腹水，慎重为佳，请复查。

 You have a good cell block. If you want to stain and save money, please do BerEP4 (mesothelial cell negative and epithelial cell positive) and calretainin (mesothelial cell positive and epithelial cells are negative). Often we do two markers for both epithelial and mesothelial cells because some cases can have unusual stains. Some times you can add CD68 for histiocytes.

Cytokeratin stains are no meaning because they are positive for both mesothelial and epithelial cells.

 Pleural fluid and 腹水cytology are relative easy. Often we need to answer the question that cells are epithelial or mesothelial cells. If they are epithelial cells, most likey they are metastatic cancer. If you are not sure what they are, please do some basic stains and do not guess. If you guess a dx, often you will be right. However I am sure that you will be wrong sometimes during the career life. It is not because you are not good enough; it is becausde that the two kinds of cells (epithelial and reactive mesothelial cells) can have similar or same cytomorphology.

As pathologists we need to learn some basic priniciple or concept for diagnosis.

 谢谢！！

赵老师平常用哪两种上皮、间皮标记？

 BerEP4, MOC31 for epithelial cells

Calretinin, WT1, CK5/6 for mesothelial cells....depending on the situation

 学习了