如果是恶性的是不是结构稍好了点，异型性好像也不明显，似乎也没有间质反应。具体的部位是不是很有意义，可能提供一个来源的可能。不认识，就是学习的，请各位老师赐教！

It is a very interesting case.

Lower power view shows vague lobular growth pattern with two components: peaceful epithelioid cells and inflammed background. No invasive nature (both epithelioid cells and stroma )of the lesion.

Higher power view reveals no cytological atypia.

 

Impression:  A florid reactive lesion of mesothelial cells should be considered, among others.

 

 脐尿管纤维腺瘤。

  

 

考虑是精囊腺的非典型腺瘤样增生或非典型腺瘤。

 考虑结直肠转移性腺癌

 期待结果

以下是引用华夏病理123在2011-4-18 21:03:00的发言：   考虑是精囊腺的非典型腺瘤样增生或非典型腺瘤。

打眼一看，像子宫内膜来源！可竟是男的？期待结果。

 来源于精囊导管的囊肿表现为直肠和膀胱基底之间的柔软的囊性肿物，后天性囊肿继发于慢性前列腺炎引起的梗阻。这例的具体部位尚需向手术医师了解清楚，图片中可以看到模糊的小叶状结构，腺上皮比较温和，没有间质反应。考虑是精囊的良性病变（囊腺瘤）。

 应该不是癌----与手术医生沟通一下（了解具体部位）

 期待结果

 如果位于膀胱顶部附近，是否考虑脐尿管肿瘤？可为腺癌，可为囊性，一般不会浸入膀胱内。 也有发生腺瘤的报道。

学习中.......

 Cystadenoma of the seminal vesicles （WHO 2004）
ICD-O code 8440/0
Cystadenomas are rare benign tumours of the seminal vesicle.
Patients range in age from 37-66 years and may be asymptomatic or have symptoms of bladder outlet obstruction {177,2292}. Ultrasound reveals a complex, solid-cystic pelvic mass {1427}.
Histologically, this is a well-circumscribed tumour containing variablesized glandular spaces with branching contours and cysts with an investing spindle cell stroma. The glands are grouped in a vaguely lobular pattern, contain pale intraluminal secretions and are lined by one or two layers of cuboidal to columnar cells. No significant cytologic atypia, mitotic activity or necrosis is seen {177,1659,2292}. Incompletely removed tumours may
recur.

 精囊腺起源于中胚层，为一对弯曲的盲管，位于前列腺的后上方。管壁迂回曲折。粘膜有高而薄的皱襞，且多分支彼此连接成网，并形成许多不规则的腔隙。被覆假复层柱状上皮，无纤毛，胞浆含糖原和脂褐素。

 呵呵，刚刚学习了一下，考虑精囊腺囊腺瘤伴慢性化脓性炎。

我进修时，老师曾经强调，精囊腺的东西很容易误诊为癌，我一直没有这方面的体会。谢谢楼主提供的好病例！

以下是引用谈东风在2011-4-7 1:11:00的发言： It is a very interesting case. Lower power view shows vague lobular growth pattern with two components: peaceful epithelioid cells and inflammed background. No invasive nature (both epithelioid cells and stroma )of the lesion. Higher power view reveals no cytological atypia.   Impression:  A florid reactive lesion of mesothelial cells should be considered, among others.

florid 中文怎么理解啊 是复杂的意思吗

 谢谢楼主提供这好病例，学习了！