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wy1992 在线

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楼主 发表于 2008-09-29 08:34|举报|关注(0)
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姓    名: ××× 性别:  女 年龄:  21
标本名称:  大网膜赘生物
简要病史:  大网膜见一3*4CM赘生物,呈乳头状
肉眼检查: 组织一块3*2*1CM,切面灰白灰黄色,边缘见一囊腔,囊液清.
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萍乡老胡 离线

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1 楼    发表于2008-10-27 22:18:00举报|引用
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 wy1992: I can not call myself an expert on soft tissue pathology.  I just want to offer my observation and one possible differential diagnosis.  This appears to be benign fibroblastic proliferation, probably a low grade fibroblastic tumor; although we have to rule out that it is not a reactive process.  On slide 2, there is a one focus of possibly dilated mucinous gland surrounded by ovarian type stroma.  Also seen on the surface is a simple lining epithelium - hard to characterize, may be mesothelial cells.  There are also many dilated thin and occasional thick walled vessels as well.  Some stromal cells also have clear cystoplasm.  With all these observations, I wonder whether this might be a tumor related to ovarian fibroma/thecoma.  Examination of entire lesion paying attention to cytologic atypia, mitoses and necrosis to rule out any possibility of sarcoma is the most important.  Additional clinical history and IHC might be helpful as well.  Thanks for sending me the message. I look forward to hearing your final answer

i think  too

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swj1960 离线

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2 楼    发表于2008-10-26 10:08:00举报|引用
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 SFT。
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liguoxia71 离线

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3 楼    发表于2008-10-25 19:12:00举报|引用
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 间皮瘤/SFT等。
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三人行,必有我师焉,择其善者而从之,其不善者而改之。

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4 楼    发表于2008-10-25 15:37:00举报|引用
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 不知道是什么东东?但是从资料上看,可以看见高柱状腺上皮,类似卵巢的间质,似有神经管样结构?是否有卵巢粘液性囊腺瘤的病变?腹腔种植?期待结果。
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5 楼    发表于2008-10-25 06:22:00举报|引用
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 Agree with above notes.

Please do CD34 for SFT,

S-100 for Schwannoma

some people mentioned GIST, please do CD117.

I favor this is a B9 lesion.

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mjma 离线

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6 楼    发表于2008-10-24 23:37:00举报|引用
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So far, no one has mentioned the possibility of desmoid tumor or fibromatosis in the differential diagnosis. The young patient age and histopathology shown here are suspicious for abdominal/mesenteric fibromatosis, an entity sometimes associated with genetic/syndromic implication. 
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cqzhao 离线

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7 楼    发表于2008-10-07 22:19:00举报|引用
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 T0: wy1992:

I sign-out only gynecologic/breast sugical specimens and cytology cases. I do not have  knowledge to mention the lesions in other organs. It is importatn to know the location of the lesion by reviewing imaging photos. What is relation of this mass to the ovaries? I agree with  njwbhuang. This tumor shares similar morphology with ovarian fibromatous tumors.  It is a benign fibroma or fibrothecoma if you told me this  is a ovarian tumor.  WT1 is positive for all ovrian fibroma/fibrothecoma (my study will be published very soon). I assume non-ovarian soft tissue tumors will be negativ for WT1. Also you can try to stain the tumor with ER. ER can be positive in GYN stroma or tumors, but not others. Occationally benign ovarian fibroma can be present in a seperated tumor with a focal connection to the ovary or no connection by imaging study result. If it is a not gyn (ovarian) fibromatous tumor, I will have no more words than above differential diagnoses and IHC all people suggested.

I am in Shanghai and sorry to answer your message late.

cqz

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gyp 离线

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8 楼    发表于2008-10-07 21:51:00举报|引用
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 考虑纤维细胞来源
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9 楼    发表于2008-10-07 20:58:00举报|引用
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以下是引用zhongshihua在2008-9-30 16:00:00的发言:

 神经源性肿瘤或GIST,免疫组化标记.

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wangdingding 离线

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10 楼    发表于2008-10-07 19:31:00举报|引用
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 考虑局限性间皮增生,期待最终结果。
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11 楼    发表于2008-10-07 17:01:00举报|引用
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我爱我家 离线

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12 楼    发表于2008-10-05 09:35:00举报|引用
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 继续学习!
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yourself 离线

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13 楼    发表于2008-10-05 08:42:00举报|引用
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 孤立性纤维型间皮瘤、SFT、神经纤维瘤是我首先考虑到的。
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树丛 离线

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14 楼    发表于2008-10-03 20:38:00举报|引用
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 胃肠外间质瘤??
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njwbhuang 离线

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15 楼    发表于2008-10-03 19:39:00举报|引用
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以下是引用stevenshen在2008-10-3 6:48:00的发言:

 wy1992: I can not call myself an expert on soft tissue pathology.  I just want to offer my observation and one possible differential diagnosis.  This appears to be benign fibroblastic proliferation, probably a low grade fibroblastic tumor; although we have to rule out that it is not a reactive process.  On slide 2, there is a one focus of possibly dilated mucinous gland surrounded by ovarian type stroma.  Also seen on the surface is a simple lining epithelium - hard to characterize, may be mesothelial cells.  There are also many dilated thin and occasional thick walled vessels as well.  Some stromal cells also have clear cystoplasm.  With all these observations, I wonder whether this might be a tumor related to ovarian fibroma/thecoma.  Examination of entire lesion paying attention to cytologic atypia, mitoses and necrosis to rule out any possibility of sarcoma is the most important.  Additional clinical history and IHC might be helpful as well.  Thanks for sending me the message. I look forward to hearing your final answer.

译文:wy1992:我对软组织病理不是很精通。我只想提出我自己的切片观察和一个可能的鉴别诊断。这似乎是一个良性的纤维母细胞性增生,可能是一个低级别纤维母细胞性肿瘤,尽管我无法排除它不是一个反应性病变。在第2张切片上,有一灶可能是扩张的黏液性腺体,周围为卵巢型间质。在表面也可见到单纯被覆的上皮,很难确定其性质,可能是间皮细胞。病变内也有许多扩张的薄壁和偶尔厚壁的血管。一些间质细胞胞质透亮。根据这些镜下特点,我猜测这是否可能是一种与卵巢纤维瘤/卵泡膜瘤相关的肿瘤,核分裂像和坏死对排除肉瘤非常重要。另外临床病史和免疫标记也有帮助。谢谢你提供这个病例,我期待你的最终诊断。
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njwbhuang 离线

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16 楼    发表于2008-10-03 19:30:00举报|引用
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以下是引用mingfuyu在2008-9-30 11:05:00的发言:

 Intersting case. Never seen before.  Differential considerations include: neuronal tumor, angiomyofibroblastoma (?), inflammatory fibrous tumor, solitary fibrous tumor, even extenstion of a tumor from abdominal or pelvic organs.  Wait for the answer.

译文:有兴趣的病例,以前从未见过。鉴别诊断考虑:神经性肿瘤、血管肌纤维母细胞瘤(?)、炎性纤维性肿瘤、孤立性纤维性肿瘤,甚至腹腔或盆腔器官的肿瘤扩散。期待最后的结果。
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wy1992 在线

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17 楼    发表于2008-10-03 11:10:00举报|引用
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 neuronal tumor maybe is the first choice!
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wy1992 在线

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18 楼    发表于2008-10-03 11:09:00举报|引用
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以下是引用stevenshen在2008-10-3 6:48:00的发言:

 wy1992: I can not call myself an expert on soft tissue pathology.  I just want to offer my observation and one possible differential diagnosis.  This appears to be benign fibroblastic proliferation, probably a low grade fibroblastic tumor; although we have to rule out that it is not a reactive process.  On slide 2, there is a one focus of possibly dilated mucinous gland surrounded by ovarian type stroma.  Also seen on the surface is a simple lining epithelium - hard to characterize, may be mesothelial cells.  There are also many dilated thin and occasional thick walled vessels as well.  Some stromal cells also have clear cystoplasm.  With all these observations, I wonder whether this might be a tumor related to ovarian fibroma/thecoma.  Examination of entire lesion paying attention to cytologic atypia, mitoses and necrosis to rule out any possibility of sarcoma is the most important.  Additional clinical history and IHC might be helpful as well.  Thanks for sending me the message. I look forward to hearing your final answer.

Thanks!You are suspicious of a tumor related to ovarian fibroma/thecoma.I think that's really a good thinking way.Thanks anyway

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19 楼    发表于2008-10-03 10:55:00举报|引用
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以下是引用江边观潮人在2008-9-30 10:19:00的发言:

 首先考虑细胞性神经鞘瘤(celluar  schwannoma), 血管肌纤维母细胞瘤或富于细胞性血管纤维瘤待排(部位不典型,太少见了)!

期待最终结果。。。
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stevenshen 离线

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20 楼    发表于2008-10-03 06:48:00举报|引用
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 wy1992: I can not call myself an expert on soft tissue pathology.  I just want to offer my observation and one possible differential diagnosis.  This appears to be benign fibroblastic proliferation, probably a low grade fibroblastic tumor; although we have to rule out that it is not a reactive process.  On slide 2, there is a one focus of possibly dilated mucinous gland surrounded by ovarian type stroma.  Also seen on the surface is a simple lining epithelium - hard to characterize, may be mesothelial cells.  There are also many dilated thin and occasional thick walled vessels as well.  Some stromal cells also have clear cystoplasm.  With all these observations, I wonder whether this might be a tumor related to ovarian fibroma/thecoma.  Examination of entire lesion paying attention to cytologic atypia, mitoses and necrosis to rule out any possibility of sarcoma is the most important.  Additional clinical history and IHC might be helpful as well.  Thanks for sending me the message. I look forward to hearing your final answer.

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