曹登峰-卵巢交界性肿瘤病理诊断.pptVIP

* * * * Here is the lesion in the patient’s parametrium. It is a low grade serous carcinoma or invasive implant. * We talked to the submitted pathologist and asked him to put more sections. He put 40 more sections. This is what we found-a small focus of invasion. According to the size criteria, it is less than 3 mm but this patient already had invasive implants or metastatic low grade serous carcinoma. * * * In epithelial implants, there is a proliferation of branching papillae with small epithelial tufts and buds present on the surfaces of the peritoneum or in smoothly contoured submesothelial invaginations. * In desmoplastic implant, the epithelium appears to merge with the desmoplastic stroma. In desmoplastic implant, the epithelium appears to merge with the desmoplastic stroma. * * * * * * * The high proportion of invasive implant associated with tumors displaying a micropapillary architecture and their aggressive behavior compared to noninvasive implants suggest that invasive implants are metastatic low grade carcinomas. * how to distinguish noninvasive implants from invasive implants? how to distinguish noninvasive implants from invasive implants? How to dinstinguish noninvasive implants from invasive implants? What are microinvasion and its significance? What is the significance of lymph node involvement? Then what is the behavior of SBTS and what is the appropriate treatment? * * * * * * 透明细胞癌 透明细胞癌（小管囊性） 透明细胞癌：小管囊性 透明细胞癌（乳头状） 透明细胞癌（实性） 透明细胞肿瘤的预后 肿瘤的类别 预后 透明细胞腺纤维瘤 良性 透明细胞交界性肿瘤（+/-上皮内癌） 偶有复发，没有病人死亡（但是病例很少！） 透明细胞交界性肿瘤伴有微浸润 病例太少，没有报道 透明细胞癌 5年存活率 I期：69%，II期：55% III期：14%，IV期：4% 争论？起源于子宫内膜异位的VS不起源于子宫内膜异位的预后是否不一样？肿瘤显微镜下的生长方式与预后的关系？ Brenner细胞肿瘤 肿瘤的类别 形态学特征 良性Brenner肿瘤 边界非常清楚的上皮巢 细胞常有核沟 高度纤维化的间质 交界性Brenner肿瘤 罕见，像非浸润性的膀胱尿路上皮肿瘤（囊内乳头状或者息肉状，内生型），背景几乎都有良性的Brenner肿瘤，还没有微浸润的病例报道 恶性Brenner肿瘤 诊断要求背景中有良性或者交界性Brenner肿瘤，有浸润，像浸润性的膀胱尿路上皮癌 WHO 2014：取消了移行细胞癌分类，认为是高级别浆液性 癌和子宫内膜样癌的一个形态学亚型 良性Brenner肿瘤 交界性Brenner 肿瘤 良性Brenner肿瘤成分 交界性Brenner肿瘤成分 交界性Brenner肿瘤 交界性Brenner肿瘤 交界