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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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本帖最后由 于 2008-09-29 17:36:00 编辑
朱正龙
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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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liguoxia71 离线
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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.
聞道有先後,術業有專攻
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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wangdingding 离线
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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. |
| 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. |
| 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 |
朱正龙
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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.
