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本帖最后由 pathology 于 2010-10-12 10:50 编辑
https://bbs.iiyi.com/forum.php?mod=viewthread&tid=1392297
https://bbs.iiyi.com/forum.php?mod=viewthread&tid=1654181
前些日子看到的印戒细胞癌病例，突然想起一篇最近看到的文献，在这里介绍一下。
活检中，我们看到印戒样细胞时，有多少时候直接给出了印戒细胞癌或者低分化腺癌的诊断？
你是否知道，除了印戒细胞癌、印戒样淋巴瘤、反应性的组织细胞/血管内皮细胞，还有一类真正上皮来源的非肿瘤性的印戒细胞，这些细胞在活检中足以让我们上当而导致过诊断、过治疗。
当然，这篇文章只是一家之言，未必完全正确，又或者所谓的非肿瘤性印戒细胞可能是印戒细胞癌的早期病变。
但看过此文后，你还敢轻易诊断印戒细胞癌吗？
Nonneoplastic signet-ring cells in the gallbladder and uterine cervix. A potential source of overdiagnosis.
Human Pathology (2009) 40, 326–331.
Summary We describe 3 cases of nonneoplastic signet-ring cell change in ulcerated mucosa, 2 of them in the gallbladder and 1 in an endocervical polyp. In the gallbladder cases, there were focal collections of signet-ring cells both on the mucosal surface and within the lumen of tubules, whereas in the endocervical polyp, the signet-ring cell aggregates were entirely confined to the mucosal surface. In all 3 cases, the signet-ring cells were positive for Mayer's mucicarmine and immunoreactive for keratin AE1/AE3. The lack of nuclear atypicality, the arrangement in superficial and intraluminal nests, and the admixture with histiocytes and other inflammatory cells are in keeping with the interpretation that the signet-ring cells are disrupted mucosal goblet cells exhibiting hyperplastic and degenerative changes. Areview of the literature disclosed only other 2 previously reported cases of benign signet-ring cell changes in the gallbladder and none—to the best of our knowledge—in an endocervical polyp. Awareness of this phenomenon is of importance to avoid a potential overdiagnosis of signet-ring cell adenocarcinoma.
AE1/AE3
AE1/AE3
[ 本帖最后由 pathology 于 2009-8-7 09:17 编辑 ] |
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发表于 2009-8-7 08:59
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发表于 2009-8-7 22:23
