慧馨 09-05 10:15

慧馨 09-05 10:15

慧馨 09-05 10:15

慧馨 09-05 10:15

慧馨 09-05 10:15

慧馨 09-05 10:15

慧馨 09-05 10:15

慧馨 09-05 10:15

慧馨 09-05 10:15

慧馨 09-05 10:15

end

山东东营 王东关 09-05 10:22

低级别癌

慧馨 09-05 10:30

有其他意见嘛

施红旗 09-05 10:38

低级别癌 +1

阿东 09-05 10:41

低级别癌 +2

燕子 09-05 10:51

怎么感觉细胞这么温和，核分裂未见。做一下CK20，CD44，P53

燕子 09-05 10:51

排除一下

慧馨 09-05 11:03

可能ck20可以帮助一下

慧馨 09-05 11:03

44，我没用过

慧馨 09-05 11:03

p53，这里不靠谱

赵某 09-05 11:04

是的免疫没有意义

赵某 09-05 11:11

punlmp和低级别都不算错，且临床处理一样，矛盾在于报punlmp显得乳头融合太多，报低级别显得异型性和极性保持太好，我自己宁愿报低级别

慧馨 09-05 11:43

@赵某 内翻

赵某 09-05 11:48

我看到孔老师的意见，但有疑虑，明显的外翻好像也有，膀胱镜下？

孔祥田(Max)*Sacramento*CA] 09-05 12:03

@慧馨 @赵某 PUNLMP can be exophytic or inverted, if you see both patterns, describe it as such. PUNLMP can be much bigger lesion as I recently forwarded a AJSP paper by Dr. Epstein in renal pelvis/ureter. Fused papilla is not a criterion to rule out PUNLMP. I need cytologic atypia to call it low grade urothelial carcinoma. You are right, the clinical management will be the same for low grade or PUNLMP. Routine cystoscopic follow up should be enough for this patient.

赵某 09-05 12:10

谢谢孔老师，您的意思是细胞的异型性是诊断PUNLMP的最主要的标准？

孔祥田(Max)*Sacramento*CA] 09-05 12:16

@赵某 cytologic atypia is necessary to call low grade. No cytologic atypia, good polarity favor PUNLMP.

慧馨 09-05 12:19

谢谢@孔祥田(Max)*Sacramento*CA] 老师

赵某 09-05 12:19

@孔祥田(Max)*Sacramento*CA] 明白了