皮脂腺上皮瘤，鉴别皮脂腺瘤和皮脂腺癌。 74岁的女朋友，呵呵，忘年交了！

考虑为皮脂腺上皮肿瘤。注意多取材观察，寻找微少浸润的可能排除癌变。

 鼻子内翻性乳头状瘤伴异型增生.

I believe this is a case of inverted papilloma, a variant od Schneiderian papillomas in the nose. Inverted papillomas are often found on the lateral nasal wall, and in about 10% of cases may have concurrent or subsequent development of associated carcinomas (mostly squamous cell carcinoma). Therefore, the entire specimen needs to be carefully examined under microscope.

 内翻

 皮脂腺癌，鉴别：反转性毛囊角化病

 皮脂腺瘤可能

 内翻性鳞状细胞乳头状瘤，伴局灶重度非典型增生，建议临床是否考虑放疗-避免复发或继续恶变。

 Agree with Dr.Ma: inverted papilloma.  Entire tissue needs to submitted.

I think those swirls are squmous pearls, not sebaceous differentiation.  Sebaceous differentiation has foamy cytoplasm.

以下是引用mingfuyu在2009-8-30 2:47:00的发言：  Agree with Dr.Ma: inverted papilloma.  Entire tissue needs to submitted. I think those swirls are squmous pearls, not sebaceous differentiation.  Sebaceous differentiation has foamy cytoplasm.

但我本人认为肿瘤是长在鼻腔皮肤表面所以不认为是内翻性乳头状瘤.我同意喻老师的观点,不认为有皮脂腺分化,因为镜下的确看不见胞浆泡沫样的皮脂腺细胞.我认为可能是一种毛外根梢或其它毛源性良性肿瘤.