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性别 | 女 | 年龄 | 49 | 临床诊断 | |
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一般病史 | No any history | ||||
标本名称 | ovarian mass | ||||
大体所见 | Right intact ovary with smooth external surface. The specimen was opened to reveal a a tan-red heterogenous cut surface with multiple tan-yellow papilary projections. Th tumor mass measured 10 cm in largest dimension. |
大图感觉有杯状细胞,因此粘液性腺癌要首先考虑,转移的一般是双侧,直径小于12cm,本例单侧卵巢受累及,原发和转移都有可能。
还是要鉴别子宫内膜样腺癌,有些子宫内膜样腺癌可以有粘液分化。。感觉不像浆液性腺癌。
转移的要考虑:结直肠癌、宫颈,胰腺胆道、阑尾等等。CK7/CK20,ER、PR、PAX8、P16、CEA等等
excellent analysis.
Pathologists shouls consider all possibities always
Above ovarian tumor case: positive for CK20, CDx2, negative for CK7, pax8, ER, PR. So it is consistent with a metastatic carcinoma, especially GI. Of cause pancreatic primary needs to be considered also. However we as pathologists cannot say 100% is a metastatic tumor.
Final diagnosis: moderately differentiated adenocarcinoma, favor GI metastatic tumor.
Lesion:
Several basic IHCs (CK20, CK7, Pax8, CDX2) are needed for all ovarian endometrioid-like carcinoma, mucinous tumor (add SMAD4 for mucinous).
I considered it is an ovarian endometrioid carcinoma in the beginning. I was surprised to get the IHC result.
This is the reason I pasted this case here
大图感觉有杯状细胞,因此粘液性腺癌要首先考虑,转移的一般是双侧,直径小于12cm,本例单侧卵巢受累及,原发和转移都有可能。
还是要鉴别子宫内膜样腺癌,有些子宫内膜样腺癌可以有粘液分化。。感觉不像浆液性腺癌。
转移的要考虑:结直肠癌、宫颈,胰腺胆道、阑尾等等。CK7/CK20,ER、PR、PAX8、P16、CEA等等
I like above the professional analysis. Thanks,
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