女，53岁。

 大量腹水。

 已破（非人为）灰白结节一个，10X7.5X5CM，包膜完整，表面光滑，切面灰白

实性质稍脆，灶性区域灰褐色。

同意

 The pictures were not wel focused and hard to see the cells, especially those look like foamy or signet ring-like cells. I basically agree with all of you. My only concern is those foamy cells. Are they steroid cells or lutenized cells seen in thecoma? or are they signet ring cells seen in Krukenburg's Tumor? We know Krukenburg's cells can be very sneaky and can mimic lot of things with variety of growth patterns. If we can exclude a metastatic ca from the stomach, I will feel more peaceful with a benign dx. I hope I can see more clearly. Another thing makes me little uncomfy is that the so-called "自发性破裂". That is very rare in a perfectly benign thecoma, but tends to see it often in malignant situation.

abin译：图片对焦不好，看不清细胞，特别那些泡沫状或印戒样的细胞。我基本上同意你们的上述意见。我只关注那些泡沫状细胞。它们是类固醇细胞，还是卵泡膜瘤的黄素化细胞？或者是Krekengerg瘤的印戒细胞？我们知道，Krekengerg瘤可能非常隐秘并且可假冒多种病变，有多种生长方式。如果能排除胃的转移癌，我会更放心下一个良性诊断。我希望能看到更清晰图片。另外使我有点不安的是所谓的“自发性破裂”。这在完全良性的卵泡膜瘤是非常罕见的，但通常更容易见于恶性情形。

谢谢大家，报告已发，卵泡膜细胞瘤。