华山论剑啊，精彩！

 谢谢！学习了。

 学习了

 谢谢！学习了。

 如果叫我发这个冰冻片只发高级别上皮瘤变（导管原位癌），建议单纯小叶切除后等待石蜡结果最实际！

 如果叫我发这个冰冻片只发高级别上皮瘤变（导管原位癌），建议单纯小叶切除后等待石蜡结果最实际！

 大家一交流就很受教育和启发。谢谢！

以下是引用stevenshen在2008-6-13 23:27:00的发言：  I enjoy the pictures very much. My opinion on this breast cancer is that of a infiltrating ductal carcinoma with DCIS component.  The invasive ductal carcinoma has so called invasive cribriform carcinoma features and focal tubular and microglandular appearances as well. The DCIS has solid and cribriform growth...I don't see clear-cut lobular features...does not appear to have neuroendocrine characteristic either.  It is a low grade cancer with low nuclear grade and rare mitose and it is proven to be ER and PR strongly positive, it is very unlikely to be a basal type carcinoma. It should be Her2 negative.  Unless for research purposes, IHC stain may not be necessary.

 

谢谢！

翻译如下：

很喜欢这些图。我认为这个乳腺恶性肿瘤是浸润性导管癌伴DCIS成分。浸润性导管癌有所谓的浸润性筛状癌特征、灶性小管癌和微腺外观。DCIS有实性和筛状方式……未见明确的小叶成分……也不像神经内分泌特征。这是低级别癌伴低核级别和罕见核分裂，ER和PR强阳性可以证实。基底样癌的可能性很小。这应该是HER2阴性。除非为了研究，IHC可能不是心要的。

 只看图，一部分似腺样囊性癌，一部分似导管内癌/小叶原位癌，不除外浸润性癌

 只看图，一部分似腺样囊性癌，一部分似导管内癌/小叶原位癌

 浸润性导管癌

 浸润性导管癌

 浸润性导管癌

 

浸润性导管癌

 I enjoy the pictures very much. My opinion on this breast cancer is that of a infiltrating ductal carcinoma with DCIS component.  The invasive ductal carcinoma has so called invasive cribriform carcinoma features and focal tubular and microglandular appearances as well. The DCIS has solid and cribriform growth...I don't see clear-cut lobular features...does not appear to have neuroendocrine characteristic either.  It is a low grade cancer with low nuclear grade and rare mitose and it is proven to be ER and PR strongly positive, it is very unlikely to be a basal type carcinoma. It should be Her2 negative.  Unless for research purposes, IHC stain may not be necessary. 

 浸润性导管癌

 浸润性导管癌

 浸润性导管癌

 翻译：

这是浸润性及原位性导管癌。有时浸润性导管癌的实性细胞巢周围受挤压，形成一圈似肌上皮的细胞（可用p63、S100等证实）。巢/管周围轮廓不规则，有促纤维反应背景，也支持浸润性恶性肿瘤。当然，也要考虑导管癌的派杰样扩展累犯硬化性腺病，但实性巢中央和小管内裤细胞的细胞学非典型性和一致性是确认无误的。我奇怪E-Cadherin 阴性，这提示小叶分化。这很罕见但确实存在，表明导管分化和小叶分化混合存在于浸润性乳腺癌中。

以下是引用城北在2008-6-10 19:19:00的发言：  癌巢周围的细胞是什么细胞？高倍如图9

This is a case of infiltrating and in situ ductal carcinoma. Infiltrating ductal carcinoma sometimes contain solid cell nests with artefactual compression of periphery, resulting in a rim of tumor cells mimicking myoepithelial cells (this can be confirmed by p63 and S100 or other immunostains specific for myoepithelial cells). The irregular contours of these nests/tubules and desmoplastic stroma in the background also support invasive malignancy. Certainly, pagetoid spread of ductal carcinoma in situ into sclerosing adenosis needs to be considered, but the cytologic atypia and monotonous appearance of the cells in the center of these solid nests or lining the small tubules are unmistakable. I am surprised that E-Cadherin stain was negative, suggesting lobular differentiation. Very rarely, mixed ductal and lobular differentiation does occur in invasive mammary carcinoma.