（鞍区）浆细胞瘤

学习了。

学习了，那么这个病人其他地方是不是也有病变，在颅脑，是不是提示比较差的预后和较高分级分期呢？

免疫组化结果：

阳性: Vimentin, Kappa light chain,CD38，VS38C, CD79α, EMA。
      弱阳性：CD138。
      阴性:Lambda light chain, LCA, CD20, CD3, CD45RO,CD56,CD10, S-100, Syn,CgA, NSE, NF, GFAP,PLAP,SMA, Myogenin, HMB45, CK。

最后诊断：（鞍区）浆细胞瘤。

大概意思就是：这是一个罕见的病例，复合性的侵袭性垂体腺瘤和神经节细胞瘤

This is probably a rare case of combined invasive pituitary adenoma (growth hormone-producing or somatotroph adenoma) and gangliocytoma. The plasmacytoid cells are somatotrophs with eccentric nuclei and fibrous bodies in pale globular cytoplasm of the adenoma component, and the larger cells with granular cytoplasm, central prominent nucleoli and frequent binucleation are ganglion cells. Growth hormone-producing pituitary adenoma is the most common pituitary adenoma seen in this rare concurrence. However, a gangliocytoma of the pituitary gland may coexist with pituitary hyperplasia, Rathke cleft cyst, sarcoidosis, or no other lesions in the pituitary gland. There are several interesting theories of pathogenesis to explain this rare combination, but none has been favored or proven to be true.

横纹肌样脑膜瘤，标记：EMA,PR,Vim,Des,MyO D1,S-100,Ki-67.同时，标记CD38,CD138与浆细胞瘤鉴别。

横纹肌样脑膜瘤

脑膜瘤

考虑横纹肌样脑膜瘤，请楼主上传结果

转移性神经内分泌癌。转移性低分化腺癌或粘液细胞癌。

恶性肿瘤，免疫组化

需免疫组化标记后诊断，浆细胞瘤、垂体腺瘤（侵袭性）可能都要考虑

淋巴瘤？鼻咽癌转移?

俺觉得诊断顺序应为：浆细胞瘤、恶黑、NEC、横纹肌样脑膜瘤（WHO III级）、恶性横纹肌样瘤--------呵呵！！！！！！！！！！！！

waiting for the final diagnosis,basophic or acidophlic?

胞浆较宽阔的上皮样细胞肿瘤，胞核中位，偏位，膜下均可见，胞浆红染、粉染、嗜双色均可见，细胞分布较弥漫，侵袭性生长（骨等），可见出血和坏死，考虑为多形性上皮样细胞恶性肿瘤，垂体内分泌细胞起源？鼻咽部神经内分泌癌？浆细胞瘤？淋巴瘤？肌源性上皮样细胞肿瘤？神经来源的。。。。。。

鼻咽癌脑转移？