图片: | |
---|---|
名称: | |
描述: | |
谢谢两位,
略加整理:
华夏病理/粉蓝医疗
为基层医院病理科提供全面解决方案,
努力让人人享有便捷准确可靠的病理诊断服务。
尝试着将王老师课件中的英文内容翻译一下,望高手指点。
Professional English in Pathology
Through a case discussion (2)
病理学专业英语
病案讨论(2)
History
8226; 36 years old male present in Emergency Room with back pain (achy), night sweat, easy bruise, and feeling tired and weak for two weeks. Physical exam identified a nodule in his axilla.
8226; Bone marrow biopsy showed focal atypical cells, but not diagnostic.
8226; He developed DIC and collapsed after the bone marrow biopsy
8226; Another core biopsy was performed for the axillary nodule
病史
1, 男,36岁,以“背部疼痛,夜间盗汗,易挫伤,虚弱和乏力感2周”于急诊室就诊。体格检查发现腋窝结节。
2, 骨髓穿刺活检示局灶性非典型细胞,但不具诊断意义。
3, 骨穿之后患者出现DIC(弥散性毛细血管内凝血)和虚脱感。
4, 随后对患者实施腋窝淋巴结针刺活检。
Diagnose
8226; Soft tissue, left axillary, core biopsy:
- Poorly differentiated malignant neoplasm.
- See comment
诊断
左腋窝软组织针刺活检:
--差(低)分化恶性肿瘤
--见备注(注解)
Comment
8226; The tumor cells are morphologically very primitive, with brisk mitosis and necrosis. Immunohistochemical stain shows the tumor cells are positive for HMB-45, CD30, pan-cytokeratin and vimentin; focally positive for S-100, Melan A and synaptophysin; negative for ALK-1, EMA, CD99, LCA, CD2, CD4, OCT3/4, PLAP, CD56, chromogranin, CK7, CK20, TTF-1, myogenin and desmin. Mucicarmine stain is also negative for mucin. Even though this staining pattern presents a somewhat unusual picture, in light of the clinical history that no distinct tumor mass was identified in the body, and the fact that the tumor cells are basically positive for HMB-45, S-100 and Melan A, a diagnosis of malignant melanoma is favored. Dr. XXXX was informed with this diagnosis
备注:
形态学上,肿瘤细胞非常的原始未分化伴有活跃的核分裂及坏死形成。免疫组化方面,肿瘤细胞表达HMB-45,CD30,P-CK(广谱角蛋白)和Vimentin;局灶表达S-100,Melan-A,Syn.不表达ALK-1,EMA,CD99,LCA,CD2,OCT3/4(译者注:生殖细胞肿瘤,特别是精原细胞瘤和胚胎性癌较为特异的标记物),PLAP,CD56,CgA,CK7,CK20, myogenin 以及 desmin等。粘液染色亦呈阴性表达。虽然肿瘤细胞在免疫组化染色方式上存在某种程度的异乎寻常的表现,但考虑到患者的临床病史即在身体其它部位并无显著的可识别的肿块性病变,以及基于肿瘤细胞基本上表达HMB-45, S-100 and Melan A这样一个事实,(最终)倾向于诊断为恶性黑色素瘤。XXXX医生提供诊断意见。