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女,42岁 右后背部肿块
灰黄、灰褐结节状组织3.0CM*2.5CM*2.0CM大小,切面灰白、质软。
本例图片采用麦克奥迪MoticBA410显微镜+MoticamPro285A摄像头采集制作。
点评专家:焦宇飞(102楼 链接:>>点击查看<< )
获奖名单:xiaocaodi(22楼 链接:>>点击查看<< )
iamsailing 离线
why not benign?
cellular atypia, frequent mitoses, tumorous necrosis,infiltrative tumor border, how can we make it a benign tumor?
Can you see the border of the tumor under such severe inflammatory background? none of these are necessary for a malignant tumor, all of these could exist in a benign disease, especially with such an inflammatory background.
I kind of agree with iamsailing. I was debating with myself about a benign process since the atypia is not dramatic and the background is quite inflammatory. If it is a benign or reactive process, those "neoplastic" cells would be best interpreted as histocytes? The high cellularity of those cells is pretty dramatic. If it is some kind of granulomatous process, there should be more cytoplasm. There does appear to have a few giant cells which may support a granulomatous lesion. In that case, it could be cat scratch disease or things along this line.
I would favor a malignant process. However, if the final answer is a benign process, I would not be too shocked:)
why not benign?
cellular atypia, frequent mitoses, tumorous necrosis,infiltrative tumor border, how can we make it a benign tumor?
Can you see the border of the tumor under such severe inflammatory background? none of these are necessary for a malignant tumor, all of these could exist in a benign disease, especially with such an inflammatory background.
just 4 this case. sorry if i have offended you.
2374263282 离线
上皮样血管内皮瘤。
1.上皮样血管内皮瘤主要见于成人,可位于浅表和深部软组织或内脏。
2.图1低倍似仍见大体血管轮廓,中央坏死机化,仅边缘残留存活的肿瘤组织。
3.肿瘤内见原始、幼稚的微血管,细胞形成小的管腔或细胞内空泡。
4.细胞核空泡状,可见核沟(血管内皮细胞常具备此特点)。
5.间质内有明显的炎细胞浸润,以嗜酸性粒细胞为主,也可见淋巴细胞。
此例核分裂像较多见,加之坏死区域多,预后应该较易发生复发甚或转移。
鉴别诊断:
1.上皮样肉瘤:结节融合状排列分式,地图状坏死。CK+。
2.转移性癌:以巢状结构为主,细胞间连接紧密,可查原发灶。CK+。
3.恶黑:细胞异型性明显,核分裂像更多,可见明显核仁。HMB45+,Melanoma+。