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- 右侧腋下肿块,乳房无肿块。请教（1楼冰冻图片,16楼石蜡图片，25楼IHC图片）（2010-9-14）
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| 姓 名： | ××× | 性别： | 女 | 年龄： | 30岁 |
| 标本名称： | 右腋下肿块 | ||||
| 简要病史： | 发现右腋下肿块1年，逐渐增大。双侧乳房无肿块。腋下肿块于真皮下。表皮无溃破。其它处未发现肿瘤。 | ||||
| 肉眼检查： | 不规则组织，局部见肿块1.7X | ||||
以下为术中冰冻切片的HE图片
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本帖最后由 于 2010-09-16 15:25:00 编辑
- 王军臣
×参考诊断
浸润性导管癌，I 级。
注：倾向来源于腋下副乳腺。
ER/PR strongly positive and also 肿块周边见乳腺腺病结构，并与其旁汗腺导管明显对比. So it is invasive ductal carcinoma or invasive tubular ca depending the percentage of tubular structure. Because 肿块周边见乳腺腺病结构，we will favor the tumor arises from 副乳腺. Clinical correlation with imaging study is suggested. Pathologists do not need to say it must be from 副乳腺tissue.
Intersting thing is the her2 stain. Clearly this is a low grade carcinoma. Generally these kinds of tumors are ER/PR strongly positive and negative for Her2. I do not know the positive and negative control for the stain. It is difficult to say the score is 3+. If it was my case, I may just call score 2 and do a FISH for her2. Her2 result (positive or negative ) is too important for clinical judgment for treatment.
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| 以下是引用cqzhao在2010-9-17 10:44:00的发言：
ER/PR strongly positive and also 肿块周边见乳腺腺病结构，并与其旁汗腺导管明显对比. So it is invasive ductal carcinoma or invasive tubular ca depending the percentage of tubular structure. Because 肿块周边见乳腺腺病结构，we will favor the tumor arises from 副乳腺. Clinical correlation with imaging study is suggested. Pathologists do not need to say it must be from 副乳腺tissue. Intersting thing is the her2 stain. Clearly this is a low grade carcinoma. Generally these kinds of tumors are ER/PR strongly positive and negative for Her2. I do not know the positive and negative control for the stain. It is difficult to say the score is 3+. If it was my case, I may just call score 2 and do a FISH for her2. Her2 result (positive or negative ) is too important for clinical judgment for treatment. |
- 王军臣
