肯定是转移吗?

 agree

 支持腺泡状软组织肉瘤

   马老师 译文如下:This is a classic case of metastatic alveolar soft part sarcoma. 本例为典型之转移性软组织腺泡状肉瘤.PAS-D stain may reveal the characteristic needle-like crystals in cytoplasm of neoplastic cells. PAS-D染色可以显示出瘤细胞泡浆内特征性的针样结晶,Patients are usually young men or teen-agers. 患者常常是年轻男性或青少年.Metastatic lesions may be multifocal in the CNS, liver and lung. 转移灶可见于中枢神经系统、肝和肺部，常为多灶性。Physical examination (or, sometimes a simple question) will reveal a soft tissue mass in the lower extremities. 查体，这是一个非常简单易行的操作，尽管简单，你将发现下肢软组织的包块。Brain metastasis is not an unusual way these unfortunate patients present themselves. 这种不幸的患者出现脑转移并不罕见。

 同意腺泡状软组织肉瘤的诊断，是不是转移不好说，脑膜软组织应该也可以发生。

需要跟副节瘤鉴别一下。

 这例如果发生在软组织，是很典型的腺泡状软组织肉瘤图像，只是在脑组织......？如果其它部位有肿块，诊断转移性腺泡状软组织肉瘤就轻易多了。还是做个PAS染色先看看吧？

This is a classic case of metastatic alveolar soft part sarcoma. PAS-D stain may reveal the characteristic needle-like crystals in cytoplasm of neoplastic cells. Patients are usually young men or teen-agers. Metastatic lesions may be multifocal in the CNS, liver and lung. Physical examination (or, sometimes a simple question) will reveal a soft tissue mass in the lower extremities. Brain metastasis is not an unusual way these unfortunate patients present themselves.

 所有组织片镜下特征均如一楼图示

 首先考虑腺泡状软组织肉瘤脑转移。

 腺泡型胶质母细胞瘤