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患者,女,75岁,排便困难伴便血一月。体检:肛管前壁可见5cm×4cm×3cm大小包块,全身浅表未见包块。术中见:距肛缘2cm肛管前壁有一5cm×3cm×3cm包块,呈息肉样,突入肠腔,表面有出血、坏死,质较硬。大体检查;灰褐色卵圆形包块一个4cm×3cm×2cm,表面有出血、坏死,切面灰白,质较硬。显微镜检查:瘤细胞主要为上皮样细胞和梭形细胞,排列呈巢状、索状,少许瘤细胞呈双核八字形及多核,散在分布,瘤细胞胞浆淡红,少许胞浆含棕褐色、大小较均匀的黑色素颗粒,核大、圆形、卵圆形、泡伏,核仁大而明显、嗜酸性染色,核分裂每高倍视野1～2个,可见病理性核
The patient, female, 75 years old, has difficulty bowel movements with feces blood in January. Physical examination: The frontal wall of the anal canal can be seen as a 5cm×4cm×3cm mass, and no superficial mass is seen in the entire body. See the operation: 2cm from the anal verge of the anal canal wall has a 5cm × 3cm × 3cm mass, was polypoid, broke into the intestine, the surface of bleeding, necrosis, hard quality. General examination; a beige-brown oval mass of 4cm × 3cm × 2cm, the surface of bleeding, necrosis, gray cut surface, hard quality. Microscopic examination: The tumor cells were mainly epithelial-like cells and spindle cells, arranged in a nest-like, cord-like arrangement. A few tumor cells presented a double-nuclear figure eight and multinuclear, scattered in the distribution, the cytoplasm of the tumor cells was reddish, a little cytoplasm contained brown, More uniform size melanin granules, large, round, oval, bubbley, large and obvious nucleoli, eosinophilic staining, 1-2 nuclear fission per high power field, visible pathological nuclear