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第182回(2004年12月10日) |
* 発表者診断 # 討論での主な対抗意見
1224 再生不良性貧血末期のEBウイルス/M蛋白の剖検例 (村尾 烈先生) Post-transplant lymphoproliferative disorder (EBV-related) 7 polymorphous 1 Immunodeficiency associated LPD (EBV-associted) 1 * EBV-associated LPD+benign monoclonal gammopathy 1 (末梢血WBC(600/μL)の過半が異型リンパ球。血清電気泳動でM蛋白はおそらくmonoclonal。臓器に浸潤したリンパ球の多くにEBER-1(+)。 Clin Exp Immunol 118: 465-472, 1999)" Lymphoproliferative disease 2 Infectious mononucleosis + aplastic anemia + hemochromatosis 1 Malignant lymphoma 5 with hemophagocytosis 1 Virus associated hemophagocytic syndrome 2 EBV-hemophagocytic lymphohistiocytosis 1 Malignant histiocytosis with VAHS + BMG 1 Multiple myeloma 2 + hemosiderosis 1 GVHD 1 non-neoplastic findings 1 IDK 3 1225 右足背病変 (山崎理恵先生) * Eccrine syringofibroadenoma 3 (国内外複数の皮膚病理医にコンサルトした回答) Fibroepithelioma 2 Lichen myxedematosus 1 Papular scleromyxedema 1 Epithelioid hemangioma 1 Angiolymphoid hyperplasia with eosinophilia (Kimura's disease/ Eosinophilic lymphoid granuloma) 2 Eosinophilic cellulitis 1 Eosinophilic dermatitis 1 Psoriasis 1 Localized pustular psoriasis 1 Lichen simplex chronicus 1 Chronic urticaria 1 Subacute dermatitis 1 Seborrheic keratotic change in allergic dermatitis 1 Reactive perforating collagenosis with melanocyte hyperplasia 1 Mycosis fungoides 1 GVHD 1 Inflammatory pseudotumor 1 Granuloma 1 # IDK 5 (上皮成分の増生は反応性変化ではないか?) 1226 軟部腫瘤の1例 (藤原久美先生) Chondrosarcoma 25 * conventional, of bone (全視野で2個の核分裂像がみられたので,grade 2) central 1 periosteal, grade 2 myxoid 1 grade 2 1 grade 1 2 Osteosarcoma 2 Periosteal chondroma 1 1227 腹壁腫瘍の1例 (新宅雅幸先生) Liposarcoma 8 well differentiated, sclerosing type pleomorphic 1 pleomorphic, with amyloidosis dedifferentiated 1 Pleomorphic / spindle cell lipoma 2 Atypical lipomatous tumor 2 * Solitary fibrous tumor 5 (巨細胞も含めてCD34(+),S100(-),MIB-1<5%。腹壁筋層内に浸潤(+)。脂肪細胞はentrapされたもの。 AJSP 19: 1286-, 1995. Mod Pathol 10: 1082-, 1997. Hum Pathol 30: 1464-, 1999) Localized fibrous tumor 1 Giant cell angiofibroma 1 Giant cell fibroblastoma 1 Pleomorphic hyalinizing angiectatic tumor 2 Fibrous tissue tumor, s/o intermediate malignancy 1 Low-grade fibromyxoid sarcoma 1 Angiomyofibroblastoma-like tumor 1 Malignant fibrous histiocytoma 2 Malignant fibrous mesothelioma 1 1228 陰嚢腫瘤 (中村聡子先生) * Leiomyosarcoma 24 (αSMA・desminともに(++),MIB-1 15% Histopathol 18: 523-, 1991) Leiomyoma 4 bizarre 1 pleomorphic 1 1229 肺腫瘍 (和仁洋治先生) * Sclerosing hemangioma 20 (AE1/3・CK7・EMA・TTF-1陽性,PgR一部陽性,CGA・Synaptophysin・CD31・CD34は陰性 気管内進展が珍しい AJSP 24: 906-, 2000. Mod Pathol 17: 252-, 2004.) Adenocarcinoma 5 Papillary 1 Bronchioloalveolar 1 ?meta. pancreatic SPT 1 Carcinoid tumor 1 Large cell neuroendocrine carcinoma 1 Adenoma 1 1230 肺門部腫瘤性病変 (三宅孝佳先生) * Clear cell ("sugar") tumor 9 PEComa 4 Sclerosing hemangioma 5 Hemangiopericytoma 1 Pulmonary capillary hemangiomatosis 1 Lymphangio(leio)myomatosis 5 Lymphangiomyoma 1 Intimal leiomyosarcoma 1 Intrapulmonary paraganglioma 1 1231 回腸嚢胞性病変 (大原信哉先生) Cystadenoma 13 mucinous 5 mucinous, ovarian type with mesenchymal stroma 1 - ectopic gastric mucosa 1 Duplication / enteric duplication cyst 2 Meckel's diverticulum 2 (Dr. K. Taguchi's coment) cystic 1 Vitelline duct remnant 1 Gastric cyst 1 Heterotopic gastric mucosa 1 Calcyfying gastric heterotopia 1 * Pancreatic heterotopia (cystic) 2 Enterogenic cyst 1 Diverticulum (pseudo) 1 Ectopic intestinal mucosa, cystic 1 Hamartomatous lesion with cyst 1 IDK 1