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- B2955乳腺肿物-诊断什么？请看免疫
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| 姓 名： | ××× | 性别： | 女 | 年龄： | 52岁 |
| 标本名称： | 左乳肿物 | ||||
| 简要病史： | |||||
| 肉眼检查： | 大小2cm*2cm*1.5cm | ||||
标签：浸润性导管癌 浸润性筛状癌 浸润性微乳头状癌
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本帖最后由 于 2010-11-16 13:05:00 编辑
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×参考诊断
| 以下是引用cqzhao在2010-11-17 4:25:00的发言：
如果混有少量浸润性微乳头状癌成分，如何写诊断？ Pure 浸润性微乳头状癌 is also an uncommon tumor. It oftenis admixed with IDC, NOS. 浸润性微乳头状癌is easy to have axillary lymph node metastasis with a relative poor prognosis. In above case, you can dx as invasive ductal ca with focal (you can give a % if you know) cribriform pattern. In the comment: you can mention focal tumor show micropapillary pattern. Generally if focal invasive micropapillary ca is asmixed with invasieve ductal ca, NOS, you can write the dx invasive ductal ca with focal invasive micropapillary ca. Because treatments are no much different (IDC vs IDC with focal micropapillary ca), it is fine if you just call IDC. |
译文：
单纯浸润性微乳头状癌也不常见，它通常与非特殊类型的浸润性导管癌混合存在。
浸润性微乳头状癌易发生腋下淋巴结转移，相对预后差一些。
就此例而言，可这样诊断：浸润性导管癌，局部筛状型（标记所占百分比）。备注：提示肿瘤局部呈微乳头状结构。
一般情况下，如果浸润性微乳头状癌与非特殊类型浸润性导管癌混合时，可诊断为浸润性导管癌，局部为浸润性微乳头状癌。因为两者在治疗上并无多大区别。如果只诊断为浸润性导管癌也问题不大。
| 以下是引用cqzhao在2010-11-17 4:11:00的发言：
两者生物学行为有差别吗？ Compared with invasive ductal ca, NOS, most cases of pure invasive cribriform carcinoma are well differentiated ca, have a low histologic grade, and have favorable prognosis. Generally the tumors are positive for ER/PR and negative for Her2/neu. tubular ca, mucinous ca, cribriform ca, medullary ca (rare for dx) are considered ca with favoable prognosis. |
译文：
与非特殊类型浸润性导管癌相比，大部分纯浸润性筛状癌分化很好，组织学级别低，有良好的预后。通常，浸润性筛状癌ER/PR阳性，Her2/neu阴性。小管癌、粘液癌、筛状癌、髓样癌都被诊为是预后较好的癌。
| 以下是引用cqzhao在2010-11-17 4:03:00的发言：
与浸润性导管癌筛状型怎么区别？ same concept. Invasive ductal carcinoma, cribriform pattern=invasive cribriform ca. Invasive ca includes invasive ca, NOS and some other subtype, such as invasive cribriform ca, apocrine ca, mucinous ca..... |
译文：
同样的概念：浸润性导管癌，筛状型=浸润性筛状癌
浸润性导管癌包括：浸润性导管癌，非特殊类型和其它亚型，如：浸润性筛状癌、浸润性大汗腺癌、粘液癌等。
| 以下是引用cqzhao在2010-11-17 3:59:00的发言：
如果全片大部分图像如前几幅表现，可诊断浸润性筛状癌吗？ If all have the same morphology as first 4 photos, you can call 浸润性筛状癌. No clear cut line for the % (like tubular ca). Some people mention >90%show cribriform pattern, then call 浸润性筛状癌. Remember that 浸润性筛状癌 is just a sub-type of invasive ductal ca. If most areas but not all show cribriform pattern, just diagnosed as IDC with focal cribriform pattern. |
谢谢！下面是译文
如果所有形态都如前4张图象，可诊断浸润性筛状癌。
没有明确百分比界限，有人提到大于90%为筛状结构则称为浸润性筛状癌。
记注：浸润性筛状癌只是浸润性导管癌的一种亚型。如果只是大部分表现筛状结构，而不是全部，就诊断浸润性导管癌，局部呈筛状结构。
如果混有少量浸润性微乳头状癌成分，如何写诊断？
Pure 浸润性微乳头状癌 is also an uncommon tumor. It oftenis admixed with IDC, NOS.
浸润性微乳头状癌is easy to have axillary lymph node metastasis with a relative poor prognosis.
In above case, you can dx as invasive ductal ca with focal (you can give a % if you know) cribriform pattern. In the comment: you can mention focal tumor show micropapillary pattern.
Generally if focal invasive micropapillary ca is asmixed with invasieve ductal ca, NOS, you can write the dx invasive ductal ca with focal invasive micropapillary ca. Because treatments are no much different (IDC vs IDC with focal micropapillary ca), it is fine if you just call IDC.
两者生物学行为有差别吗？
Compared with invasive ductal ca, NOS, most cases of pure invasive cribriform carcinoma are well differentiated ca, have a low histologic grade, and have favorable prognosis. Generally the tumors are positive for ER/PR and negative for Her2/neu.
tubular ca, mucinous ca, cribriform ca, medullary ca (rare for dx) are considered ca with favoable prognosis.
如果全片大部分图像如前几幅表现，可诊断浸润性筛状癌吗？
If all have the same morphology as first 4 photos, you can call 浸润性筛状癌.
No clear cut line for the % (like tubular ca). Some people mention >90%show cribriform pattern, then call 浸润性筛状癌.
Remember that 浸润性筛状癌 is just a sub-type of invasive ductal ca. If most areas but not all show cribriform pattern, just diagnosed as IDC with focal cribriform pattern.
