女  48岁    乳肿肿块。

中等级别DCIS

DCIS

导管内癌，待排除浸润

DCIS

DCIS

脉管内癌栓是否要写入报告

图片亮度不够，隐约有原位癌的地方，但图1、2、3、4更应该是癌栓，因此多取材，排除浸润癌

 DCIS。

DCIS, Nuclear 2,  solid type with central necrosis and calcification

If it is true, you must report. Patient may have invasive carcinoma. If this is total mastectomy specimen, you need to gross the specimen and submit more sections. If it is a partial mastectomy, you have to submit entire specimen for microscopic examination.

If you are not sure if it is lymph-vascular invasion, you can do endothelial staining, such as D2-40 and CD31.

Do not write your report like above often.

Pathologists should try to make the definite dx. Of cause you try your best and still cannot make the definite dx, you can use it occasionally.

导管原位癌，但图1、2、3、4更应该是癌栓，因此应多取材，排除浸润癌。

高级别导管内癌，感觉脉管内有癌栓， 多处取材看有无浸润。

导管内癌

高级别导管内癌，脉管内见癌栓，多取材仔细寻找，是否有浸润。

有无做过穿刺？有时穿刺会造成这种改变。

高级别导管原位癌，但是要多取材切片，看看有没有浸润癌，没有浸润脉管内癌栓不好解释啊，免疫组化看看是否是脉管，是不是组织没及时固定造成的假象啊。

导管内癌，待排除浸润,建议免疫组化检查确诊。

乳腺导管浸润癌