多行性腺瘤

 混合瘤，恶性好像缺点哦 

 good case

界限清，有些细胞形态不好，我不敢确定是否恶性了，等待高手点评。

 This case may represent an atypical Apocrine Mixed Tumor (AMT) with prominent myxoid changes. To call a lesion malignant AMT, you need have the benign component, this case for sure has those parts....but malignant AMT is extremely rare skin tumor which in my opinion is still over-diagnosed. To call it malignant AMT, besides the benign component of AMT, you need frank malignant carcinoma component, either apocrine adenocarcinoma, myoepithelial carcinoma, or sarcomatoid carcinoma. you need really UGLY tumor cells with multiple mitoses including abnormal ones, you need infiltrative growth pattern which I did not see in this case.(maybe there is, just not shown here).. so given the focal atypia present ( remember even benign apocrine neoplasms are normally "atypical" in histology), I would conservatively give it a dx of atypical AMT or AMT with atypia. Since the biopsy edges are involved, it need be out anyway,,,

个人觉得恶性还不够，但是最后几张图片特写确实有见到一些轻度异型性，是否考虑混合瘤不典型增生？中间状态？

还请老师点评。

 诊断基本符合皮肤混合瘤，异性不十分明显，没有低倍照片，病变界限是否清楚，有无明显灶状异性改变或浸润性生长？目前只能考虑可能存在非典型增生。