本帖最后由 pathology 于 2014-9-30 14:37 编辑
本周病例(2014.9.1—2014.9.14)
1、你考虑什么诊断?
转移性绒毛膜癌,可能源自胎盘(metastatic choriocarcinoma, most likely from placental primary)
Infantile choriocarcinoma is very rare, and is presumed to be due to placental choriocarcinoma. The mothers usually have a normal pregnancy and no history of gestational trophoblastic disease. The placenta usually appears grossly normal, and the area of tumor resembles a placental infarct. Clinically, there usually are maternal metastases at diagnosis, but neonatal metastases of placental choriocarcinoma are rare. The clinical diagnosis is based on high maternal and pediatric serum or urinary levels of hCG or beta-hCG.
2、需要做什么鉴别诊断?
间变性横纹肌肉瘤、转移性卵巢生殖细胞肿瘤、幼年性黄色肉芽肿等
3、本病预后如何?
不经治疗,发生于幼儿的绒癌是高度致命的。早期积极的化疗方案则常常可以治愈本病。
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本期病例比较少见,一旦考虑到本病的存在,辅以免疫组化不难诊断。综合回答思路,molly011累积半分,派瑞松、rattlebox鲜花鼓励!
希望大家一如既往的支持病理每周一题, |