腺癌。

这例涂片做得好，不仅没见红细胞，涂得均匀，而且异型腺细胞团及其乳头状结构很显明。

单侧恶性胸水多半是同侧肺源的。

 Depending on the situation in your hospital.

We always work on for these kinds of cases. Two purposes: confirm the nature of the cells; try to find the origin.

If it was my case above, I would stain at least Ber-EP4, Calretinin, (generally two epithelial markers and two mesothelial markers), CK7, CK20, TTF1. Will decide the next step when I see the stain results. We should try our best to provide more pathology information to clinicians.

Nice photos, thanks.

For your reference

 腺癌

 增大的异形细胞，明显比小淋巴细胞大，而且形态失常，细胞团内细胞大小不一，核浆比增大。恶性肿瘤，多半是腺癌。

图片选得好，主要是肿瘤细胞周围可以看见各种平时能见到的正常细胞，能作为观察异常细胞的参照。虽然HE染胸腹水，胞核有时没有瑞氏清晰，但是核再清晰，放大倍数甚至是油镜，如果看不到周围的正常细胞，要报恶性肿瘤细胞，心里老觉得不踏实。