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- 51岁，双侧卵巢肿瘤
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| 姓 名： | ××× | 性别： | 女 | 年龄： | 51岁 |
| 标本名称： | 双侧卵巢肿瘤 | ||||
| 简要病史： | 检查胃肠道等无异常发现 | ||||
| 肉眼检查： | 双侧卵巢囊实性肿瘤，均约9cm*8cm*7cm大小 | ||||
标签：卵巢 恶性间皮瘤
知之者不如好之者，好之者不如乐之者。（语出幽梦影）
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×参考诊断
IHC
ck7, ck20, ae1/ae3, CDX2
ER, PR
AFP, CD30, EMA
WT1, calretinin, inhibin, ck5/6
Above IHC stains should tell the tumor is primary , secondary tumors or mesohtelioma; If it is an ovarian primary tumor the IHC stains can tell it is an epithelial tumor, sex cord-stromal tumor, or germ cell tumor.
If IHC stains confirm it is ovarian epithelial malignancy. Differential dx: include serous and clear cell tumor.
Serous: p53,WT1, p16 are strongly positive.CCC can be positive for these markers, but they are weak and focal in most cases. The chance of endometrial tumor is low based on the photos.
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favor 原发性上皮性恶性性肿瘤，不能分类: consider high grade serous or transtional (malignant Brenner tumor). Main goal will be rule out metastasis (clinical more effective). Less likely to be sex cord stromal or malignant germ cell tumor. Good to see Dr. Bing Yang's comments. Great lecture last Saturday.
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Whenever you have a bilateral malignant tumor with high grde features like this one, you should first to rule out a metastatic carcinoma. High grade serous adenocarcinoma is on the top differential list for primary ovarian carcinoma since bilaterality is not uncommon in serous adenocarcinoma. One of the useful markers is to see if tumor cells are positive for WT-1, a marker often labeling mullerian epithelium. Also up to 50% of serous adenocarcinoma will be positive for ER and PR. For metastatic cancer (mostly from GI tract), CK20 is a good marker to differentiate metastatic carcinoma from coorectal or stomach from primary serous adenocarcinoma, provide no mucinous differentiation seen in this tumor anywhere else.
- 不坠青云之志，长怀赤子之心
