软组织肿瘤 病理学病例讨论 七课件.pptVIP

Benign Metastasizing Leiomyoma 良性转移平滑瘤 PCR of AR Summary of BML Multiple small benign looking leiomyomatous lesions in the lung They are derived from uterine leiomyoma Clinicopathological Correlation Pathological diagnosis important This condition can be controlled by anti-hormonal (anti-ER and anti-PR) treatment Surgery may be effective in solitary lesions Case 8(2159 胜利石油管理局滨南医院 105-04) 讨 论 会诊意见 免疫组化 Case 9 (2181 济宁市第一人民医院 034351) 讨 论 会诊意见 * Our Diagnosis: B D E F C I G H A Case 1 Case 2 Case 3 Lung Low power Lung High Power Uterus E A D F I G C B H PR ER Ki-67 Lung Tumor 1 Lung Tumor 2 Uterine Tumor XX XX XX Uterine Tumor Lung Tumor XX Clonal Non-Clonal A F D C E B Figure 3. Fluorescent in situ hybridization assay for estimating telomere length. A, B, bronchus and normal lung showing normal length (long) telomeres. C, Pulmonary tumor from Patient 1 with signals stronger than surrounding normal tissue (long telomeres). E, Uterine tumor from Patient 1 with signals stronger than surrounding normal tissue (long telomeres). D, Pulmonary tumor from Patient 2 with signals similar to resident lymphocytes (very long telomeres). F, Uterine tumor from Patient 2 with signals similar to resident lymphocytes (very long telomeres). Very long Very long Long Lelomere length yes Noninformative yes Monoclonality +/+ (100%) +/+ (100%) +/+ (100%) ER/PR 5/1,000 5/1,000 5/1,000 Ki-67 index 1/50 hpf 1/50 hpf 1/50 hpf Mitosis no no no Atypia no no no Necrosis moderate low low Cellularity multiple multiple multiple Number lung tumors 6 15 9 Largest lung tumor(mm) 60 41 2 Interval(months)* yes yes yes Uterine tumor 44 37 44 Age (years) Patient 3 Patient 2 Patient 1 男 58岁 右大腿内侧肿物 发现右下肢内侧肿物伴疼痛右下肢麻木半年。余　　检查均（－）。PE：右大腿内侧可触及一大　　小约4×3cm肿物，质韧，触痛，边界尚清，　　活动度欠佳。 手术见肿物位于右大腿内侧，近侧大小约2×　　　2cm，远侧大小4×4cm，二肿物相距3cm。　　肿物质硬，与周围组织粘连，股神经束贯穿 　　　其中，粘连明显，压迫股神经股动脉，　　 切除部分肿物送检。 标本检查：灰红色不规则组织两块，体积分别　　为3×2×1cm，1×1×0.5cm，大者灰　　红