“毛”是哪来的

细胞也有问题

 腹水中细胞团有立体感、细胞异型性明显，有清晰的核仁，有分泌空泡 ，符合腺癌特征。    

 谢谢楼主为大家分享了这么好的病例！

反应性间皮。

  我看了大量国外和国内资料，给大家总结一下：

微小绒毛可见良性间皮细胞、间皮瘤、卵巢癌、乳腺癌和胃癌细胞。但是，卵巢癌肿瘤细胞微绒毛长度一般分布长短不一，比良性间皮细胞微绒毛更长，通常出现在细胞一极，也叫假绒毛，但是也可能整个细胞覆着微绒毛，微绒毛也可以出现在乳腺癌、间皮瘤和胃癌细胞，但是腹水中的卵巢癌细胞常见。巴氏染色很难看到微绒毛，巴格氏染色（Romanowsky Stained ）和瑞氏吉姆萨染色更能清楚可见了，近来有报道糖原染色也可见微绒毛。但是需要提醒大家，是恶性还是良性，需要结合细胞核和胞浆特点来判断。

为什么就不是反应性间皮呢？而一定是肿瘤？？？？？老外只是说不是恶性间皮瘤。而在卵巢有“浆液性乳头状囊腺癌”。说腹水中出现的细胞就是癌细胞，无形态学依据，无免疫组化依据。it's pointless and baseless.

认真复习过后，仍感觉细胞形态有重叠，不能根据一个诊断标准进行诊断。

增生间皮或间皮瘤

增生间皮细胞？或间皮瘤

间皮来源肿瘤？

 腹水中见细胞异型性明显，有清晰的核仁，有分泌空泡+微绒毛（比良性间皮细胞微绒毛更长），考虑卵巢癌，是这个意思吧？谢谢楼主为大家分享了这么好的病例！

这个腹水的细胞，看上去是间皮细胞，并不是说是卵巢癌，腹水就一定有癌细胞

 学习了

学习！

细胞病理在不断总结中前进，谢谢楼主总结的这一条经验

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  卵巢乳头状癌 Papillary carcinoma of ovary

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  Anemone cells: the presence of many microvilli in malignant cells is frequently documented by electron microscopy (EM), but their presence can be seen in some cases by optical microscopy as well. The use of Romanovsky stains can be very useful in this context ( I use to say they are the EM of the poor...). Spriggs and Boddington, in their classic book Cytology of effusions, Grune & Stratton, 1968, 2nd edition, were the first to call attention to this finding in papillary carcinomas of the ovary, with pictures remarkably similar to the ones in our cases. More recently, this finding has been called "anemone cells" and "anemone tumors" in relation to the cells or the tumors bearing them, respectively.  This case illustrates the difficult differential diagnosis between this type of tumor and mesothelioma, in special of the surface of the ovary and the pelvic peritoneum. Both tumors may exhibit windows between the cells, and microvilli in their surface. There is no immunochemistry test of real value, and the only certainty is done by the surgical exploration, as done in this case, where the pelvic peritoneum was free of disease, and the ovary had a typical serous cystadenocarcinoma papillary tumor. Their coelomic epithelial common origin explains their extreme similarities. Sometimes they both have ciliated cells besides microvilli in their surface.

 只看图片会考虑恶性间皮瘤。