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| 以下是引用yangjun在2008-1-14 21:07:00的发言： 这例很可能是浸润癌，理由有：1、扩张性的大面积累腺，2、所谓累腺的细胞巢边缘已不“圆滑”，没有保持原腺体的形态，3、累腺细胞核有的地方并没有栅栏状基底细胞的排列方式。片子好些，多找几个区域应有更典型的浸润。 |
I agree with Yangjun's opinion. This is an "early invasive squamous carcinoma" till prove otherwise. Evidences support invasive SCC based on: 1) tumor mass formation. CIS should not form a tumor mass. 2) stromal invasion with desmoplastic reaction.3) plus yangjun mentioned above. For clinicians, two more peremeters are important for them to know as long as you render the diagnosis of invasive SCC: 1) presence or absence of angiolymphatic invasion, which I did not see from photos provided, but need carefully search for; 2)tumor mass and depth of invasion. I can forsee the measurement may be problematic since the orientation in this case.
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本帖最后由 于 2008-01-17 11:55:00 编辑
| 以下是引用杨斌在2008-1-16 0:45:00的发言：
I agree with Yangjun's opinion. This is an "early invasive squamous carcinoma" till prove otherwise. Evidences support invasive SCC based on: 1) tumor mass formation. CIS should not form a tumor mass. 2) stromal invasion with desmoplastic reaction.3) plus yangjun mentioned above. For clinicians, two more peremeters are important for them to know as long as you render the diagnosis of invasive SCC: 1) presence or absence of angiolymphatic invasion, which I did not see from photos provided, but need carefully search for; 2)tumor mass and depth of invasion. I can forsee the measurement may be problematic since the orientation in this case. |
杨老师的回复大意如下
我同意Yangjun的意见，这例可能是早期浸润性鳞状细胞癌，除非证明不是。支持浸润癌的证据：1)瘤块形成，原位癌不形成瘤块；2）间质促纤维反应；3)Yangjun谈到的以上几点。一旦诊断浸润性鳞状细胞癌，有很重要的两点应告知临床医生：1）是否有淋巴管血管浸润，从本例提供的图片看不到，但应仔细寻找；2）肿瘤浸润的深度，本例判断有困难因为方向不明确。
