图片: | |
---|---|
名称: | |
描述: | |
性别 | 女 | 年龄 | 61岁 | 临床诊断 | 待查 |
---|---|---|---|---|---|
一般病史 | 绝经15年,发现“阴道壁囊肿”5年 | ||||
标本名称 | 阴道壁囊肿 | ||||
大体所见 | 亮白色实性包块1枚,3.5cm×3cm×2.5cm,切片亮白色,质软,中心稍韧。 |
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:王曦(60楼 链接:>>点击查看<< )
获奖名单:lanyueliang(15楼 链接:>>点击查看<< )
知之者不如好之者,好之者不如乐之者。(语出幽梦影)
xiaoqingting 离线
chengrunfen 离线
benben520sps 离线
The differential diagnosis for this kind of lesion in this location includes 1) aggressive angiomyxoma, 2) fibroepithelial stromal polyp, 3) angiomyofibroblastoma, 4) cellular angiofibroma, 5) superficial angiomyxoma, 6) superficial myofibroblastoma, and 7) leiomyoma. To be honest, at least for #2 to #6, their morphology and IHC pattern are quite similar, often with only subtle differences. Some pathologists would consider them as from the same stem cell origin with variable tendency of differentiation. Therefore, I would think it is more important to recognize that it is benign, and it is in this category. What exactly the name to use is not really that important. Having said that, the original hospital's diagnosis for this case is "superficial myofibroblastoma". The tumor cells are reported to be positive for ER, PR and desmin, negative for CD34 and caldesmon. I would agree with this diagnosis, as the tumor appears demarcated with a thin rim of stroma to separate it from the mucosa (so not the #1, may not be the #2), the vasculature is not prominent, even though exists, and no apparent perivascular epithelioid cells seen (so may not be #3-5). The staining pattern is consistent with this entity, even though not necessarily exclude others either. You probably have heard of myofibroblastoma from breast pathology. This is pretty much the same entity, but outside of mammary gland. It can have variable morphological pattern, and CD34 could be positive or negative.
Of course, no one has really made the exact call in this case. But as I said, it does not really matter. I think Lanyueliang did very well with the analysis of this case, so I would recommend he/she be the winner.