片子经过重切，和上传图差不多。 

最后诊断：

（支气管活检）粘膜慢性炎伴局灶挤压、变形细胞

备注：请结合临床，必要时重新活检。

 疑癌。

同意以上意见。

凭这张片诊断恶性肿瘤－鳞癌或者小细胞癌太危险了。组织太少，细胞人为变态较严重，是鳞状上皮细胞还是纤毛柱状上皮细胞还很难说，需结合临床如胸片，患者症状等考虑。先提示临床“活检组织中见少量异形细胞团，但变形严重，建议再取活检”为好。

同意，组织有一定程度挤压，组织结构、细胞形态均变形。先以不诊断恶性为好，建议再取活检。

 Poorly differentiated carcinoma.  I personally don'st favor small cell undifferentiated cancer because these cells are quite large (small cell carcinoma cells are <3x the size of lymphocytes), no typical molding, and have some cytoplasm, especially the last picture.  Small cell carcinoma usually dont have much cytoplasm.  The tumor cells are almost pleomorphic with ?squamous differentiation.  If you cannot cut more sections for immunostains, can you destain H&E sections and restain with neuroendocrine markers ?

My experience is: you have to make decision of cancer or not cancer on H&E sections in the lung.  Immunostains only help you with what type of cancer.

鳞化的纤毛柱状上皮，有非典型性，癌不够。试着这点标记看看如何？

鳞化的纤毛柱状上皮，有非典型性，癌不够。试着这点标记看看如何？