W***M
发帖数: 50 | 1 She should have a bone marrow aspiration/biopsy to rule out myelodysplastic
syndrome (MDS). It is a simple procedure, can be done by local anaesthesia.
It takes only a few minutes to do the procedure and it is very safe. She
should not delay diagnosis. |
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f****o
发帖数: 2770 | 2 what's your hemoglobin level?and platelet level?
are those normal?
if they are low as well, maybe u need a bone marrow biopsy |
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j****i
发帖数: 496 | 3 In my latest lab, HgB and platelet are finally within normal range (although
still borderline low). In the past, they have been low more often than not
since I was a kid. The WBC drop along with those annoying symptoms, however
, is quite significant and fairly recent. I am HIV neg, no cold/flu either,
and this has gone longer than a normal course of viral infection. Bone
marrow biopsy sounds very scary. What kind of diagnosis can it reveal or
rule out? |
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w***0
发帖数: 222 | 6 Biopsy only. However, Barium enema provides very close information for
diagnosis. |
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j*****A
发帖数: 1395 | 8 为啥不自己用冷冻法除掉?【 在 dawangzi (大王子*催贝卡) 的大作中提到: 】 |
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d******i
发帖数: 7160 | 9 DIY会比医生更专业吗。
医生给用刀割的一块下来，lab检验说abnormal。
于是又要去多割一块进一步检验。
担忧不知啥叫abnormal。 |
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j*****A
发帖数: 1395 | 10 亚洲人得皮肤癌的几率是几十万分之一。
通常黑痣都是良性的，只有出现下面情况，才考虑看医生：
1。
短期内迅速增大，颜色变深或不均匀；
②溃烂、出血、结痂；
③周围出现红晕或出现卫星痣；
④突然发生明显痒感或刺痛等。
如果是良性黑痣，完全可以DIY. |
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b********i
发帖数: 1252 | 11 还是老毛病，
可能这里的兄弟姐妹们都认识我了
现在正在吃奥美拉唑
因为医生是按GERD甚至是Barrett Esophagus来治的
每天一片
告诉我说这药没啥副作用
吃个7、8年也许要担心体内钙吸收所以需要补钙
所以就一直吃
医生的意思是一辈子
我想请问这里的朋友们
（1）如果是中国，也是这么治的吗？
（2）我怎么知道一天一片的量是不是多了或者少了？
（3）吃着奥美拉唑还时不时难受，大家有和我类似的吗？
（4）胃镜检查胃里的组织比较红于是作了biopsy没有发现什么异常，医生也说不上是
怎么了，请问可能是什么原因造成的？
多谢指点了 |
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x****m
发帖数: 13 | 12 多谢回复！
Why do you choose mastecomy bilaterally, not left breast only?
双侧全切的原因有几点，第一是我父亲是胰腺癌去世的，担心有些遗传的原因以后风险
会非常大；第二是我的年纪尚轻，另外一个乳房患癌几率仍然比一般人高很多；第三是
同天乳房重建手术双侧重建也方便些。
What is your breast cancer staging?
现在仍不能最近确定是第几个stage，但是根据肿块大小4.5cm（肿块里面不全是病变，
呈现7－8个分散的小病灶），还有淋巴结没有肿大，ct和骨扫描没有检测到转移，医生
说估计是2 或者 3 stage....
Do they tell you the prognosis?
我的外科医生很乐观的人，说是能够治愈的。。。谁知道是不是在安慰我呢。。。
Do you need chemo or radiation after?
我的癌症医生说根据手术后病理检查结果来决定，但是基本上可能是需要做化疗的，四
个月的疗程。放疗现在还不知道需要不需要。。。
You need get your biospy... 阅读全帖 |
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y**********u
发帖数: 6366 | 13 bless...
作ultrasound发现一个1.1*1.9 cm肿块在甲状腺中间偏右，立马推荐了oncologist医生
#2, 然后作biopsy，结果是 “Suspicious for Papillary Thyroid Carcinoma”, 医
生#2说了由50%的概率是癌，要切除: 祝大家龙年身体健康，生龙活虎！ |
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y**********u
发帖数: 6366 | 14 bless...
作ultrasound发现一个1.1*1.9 cm肿块在甲状腺中间偏右，立马推荐了oncologist医生
#2, 然后作biopsy，结果是 “Suspicious for Papillary Thyroid Carcinoma”, 医
生#2说了由50%的概率是癌，要切除: 祝大家龙年身体健康，生龙活虎！ |
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j****d
发帖数: 123 | 15 1. 这样的情况应该做PET检查吗？
yes, do it right now. PET scan is not invasive.
If PET scan result is positive, then you consider biopsy or bronchoscopy, or
needle aspiration, which are all invasive.
Statistically, 40% solid pulmonary nodules turn out to be cancer/malignant
医生根据CT做良性考虑 - stay away from this doctor! |
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u*******r
发帖数: 2855 | 16 一直都有花粉过敏。但是从这个星期三晚上开始，右边的鼻子，眼睛，及附近的脸部开
始有一些疼痛感，有点发涨，右边的牙齿也有一点疼，有低烧（37-38），开始的时候
有磕嗖，并能磕出黄绿色的浓痰，但今天就不咳嗖了，但喉咙还是有一点疼。一开始的
时候以为是发烧，但后来觉得以前发烧的时候从来没有脸部的疼痛感，今天查了一下网
上的资料，发现可能是感染引起的鼻窦炎。这两天症状没有恶化，准备下个星期一去看
医生，大家觉得有必要周末去看急诊么？另外大家帮忙看看有什么建议，谢谢！另外，
我上个星期二做了一个parathyroid的biopsy检查。 |
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j****d
发帖数: 123 | 17 对一部分在中国的肺癌患者,这是个极好的消息
新药 XALKORI (crizotinib) 药试在, 北京,南京,上海,广州, 已经开始.
免费!
这是临床二期 [无对照组]: 人人得药;
[不是临床三期: 对照组得安慰剂/对照药/老药]
条件: ALK 基因重组活检阳性
FISH biopsy ALK gene rearrangement positive (translocation or inversion) to
qualify. Contact me or NIH site if you need more information.
美国价格$9,500/月[保险公司价] |
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j****d
发帖数: 123 | 18 对一部分在中国的肺癌患者,这是个极好的消息
新药 XALKORI (crizotinib) 药试在, 北京,南京,上海,广州, 已经开始.
免费!
这是临床二期 [无对照组]: 人人得药;
[不是临床三期: 对照组得安慰剂/对照药/老药]
条件: ALK 基因重组活检阳性
FISH biopsy ALK gene rearrangement positive (translocation or inversion) to
qualify. Contact me or NIH site if you need more information.
美国价格$9,500/月[保险公司价] |
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S**********r
发帖数: 226 | 19 一次普通的体检发现calcium level偏高，然后家庭医生推荐去看specialist。
specialist让我去做了parathyroid ultrasound和Scan，发现有甲状腺内部有一个类似
parathyroid或者belign tumor的东西over-reacting，然后让我吃vitamin D，8个星期
后再次验血，parathyroid hormone含量从110多下降到80多（仍然稍高于60多的正常水
平），然后
calcium level还是11，所以specialist让我去做biopsy，下个星期才知道结果.不过他
说告诉我可能是overreacting parathyroid或者bilign thyroid tumor之一，都需要做
手术。在版上看了一下,好象大家都甲状腺瘤的情况下可以做手术也可以不做.
在这里请教专家，医生的建议和诊断合理么？这个parathyroid的问题严重么？需要做
手术么？ |
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S**********r
发帖数: 226 | 20 一次普通的体检发现calcium level偏高，然后家庭医生推荐去看specialist。
specialist让我去做了parathyroid ultrasound和Scan，发现有一个类似parathyroid
或者belign tumor的东西over-reacting，然后让我吃vitamin D，8个星期后再次验血
，parathyroid hormone含量从110多下降到80多（仍然稍高于60多的正常水平），然后
calcium level还是11，所以specialist让我去做biopsy，告诉我可能是overreacting
parathyroid或者bilign thyroid tumor之一，都需要做手术。
在这里请教专家，医生的建议和诊断合理么？这个parathyroid的问题严重么？需要做
手术么？
谢谢！ |
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t***a
发帖数: 2813 | 21 我做了胃镜，大夫取了样做活检，还好没啥事。但是Barrett's我不知道什么意思。
biopsy is benigh and negative for Barrett's esophafus. |
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f*******l
发帖数: 66 | 23 朋友最近检查得了cancer，
具体的biopsy还在进行中。
现在在考虑是回国治疗还是留在美国。
据网上查的资料看，在美国从诊断到进入治疗可能需要很长时间(需要预约医生，
看医生的时间安排手术)，但美国可能有一套完备的方案，医疗水平更高(?).
回国已经联系好医生，可以尽快动手术，但是对于整个治疗方案，治疗水平不放心。
这些假设都是基于不完备的信息，急求各位建议是立即回国治还是继续呆在这边？她父
母非常着急！
感谢各位！
万能的买买提！ |
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l*h
发帖数: 4124 | 24 过敏性紫癜 in children is usually benign but in adults, should be treated as
a serious systemic disease unless thorough examination shows no signs of
kidney damage.
the key of the skin presentation is 紫癜, not 斑块. the pain is in deep
tissues, typically large joints or abdominal organs, not the skin itself.
if there is no signs of kidney damage, a skin biopsy can be performed to
establish diagnosis. pathology shows IgA vasculitis.
你。 |
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l*h
发帖数: 4124 | 25 was this diagnosed by biopsy or just urinalysis etc? it can be very
different based on the criteria of diagnosis, clinical presentation etc.
啊？ |
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h*******g
发帖数: 37 | 26 到底是怎么诊断的具体不太清楚啊，一开始是尿检，后来又去大医院检查，不知道是不
是biopsy，最后确诊为IGA血管炎型肾病，现在已在国内开始治疗了。估计得推迟入学
了。
不知道这种病在美国治疗水平怎么样，是不是比国内好呢？
非常感谢！ |
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V******n
发帖数: 98 | 27 做肝赃biopsy 被手术医生扎了胆囊，不得不将胆囊摘除
如是，我该怎么告他 |
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t*******n
发帖数: 4445 | 28 Gallbladder puncture is listed among risks of this procedure, so you need to
prove that the doctor's care was substandard
http://www.mayoclinic.com/health/liver-biopsy/MY00949/DSECTION=
Consult a lawyer specializing in medical practice
Also decide what you want: paying medical bills, compensation or punitive
damages,etc. |
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l*h
发帖数: 4124 | 29 I think I need to clarify what I meant in the other post:
喉部肉芽肿 is common and I DO think it is possible this is a 喉部肉芽肿.
What makes people mad is the contradictory description by the surgeon and
the pathologist. Additional questions are:
1. the vast majority of laryngal granulomas can be resected fairly
completely, unless it is too big and gets deep into the vocal cords. so don'
t know why the surgeon says 由于她长的是肉芽组织且是良性，据国内的医生说不太
好治疗.
2. what was actually done? what's the use of 氩氦刀 here? "氩氦刀进... 阅读全帖 |
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u*****t
发帖数: 292 | 30 I agree with the impression, most likely germ cell tumor. I would recommend
a CT for chest, abdomen and pelvis with contrast to look for possible
primaries. And if found, they may be able to do a CT guided biopsy.
I am not a pediatric oncologist, but BEP (bleomycin, etoposide, and
cisplatin) x 4 or VIP (etoposide, ifosfamide and cisplatin) x 4 works well
in adult patients. Armstrong had brain mets too and he got the VIP regimen
because he wanted to preserve his lung function. He is cured BT... 阅读全帖 |
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u*****t
发帖数: 292 | 31 I read lmh's note carefully and agree with him/her.
Here is my thoughts:
Her Alpha fetoprotein is normal. it is often elevated in non-seminona germ
cell tumors.
I still recommend CT scan, serum LDH and biopsy to get path to stop the
guessing games. Is lumbar puncture safe?
Also consider dexamethasone because she might have brain edema.
best of luck. |
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l*h
发帖数: 4124 | 32 AFP: yolk sac tumors, 100%.
biopsy can be done but is strongly discouraged because these tumors are
highly vascular and debulking doesn't improve outcome, ie, risk outweighs
potential benefit.
lumbar puncture: it depends on whether she has CSF blockage and if yes,
where the blockage is.
dexamethasone is routinely given if brain edema is suspected. it is also
routinely given during radiation and in some cases chemotherapy.
germ |
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l*h
发帖数: 4124 | 33 this is a case that there is no standard answer to the question what to do
next in the short term. if you go to different doctors, you will get
different opinions that can be mainly classified as the following:
1. close follow-up with MRI, do nothing in the interim.
2. close follow-up with MRI, treat as demyelinating disease in the interim.
3. biopsy.
if the description of her symptoms is accurate, the probability of a
demyelinating disease (such as multiple sclerosis) is much higher than other
... 阅读全帖 |
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d********1
发帖数: 77 | 34 3X a lot for your detailed response!
The description of her symptoms is as accurate as I can describe (she has
some 腿麻, 胳膊麻 etc lately. Her numbness is sometimes on the left or right
leg, arm, toes, fingers, and even face, but never on all these places at
the same time).
She did not have obvious limb weakness.
What do you mean by "seizure"? 抽搐/癫痫？If so, she does not have it. But
some times (very occasionally, I would say less than 6 times a year in
recent years), she has brief leg/foot抽筋。Not sur... 阅读全帖 |
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f****o
发帖数: 2770 | 36 what hospital?
biopsy not done? |
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t******4
发帖数: 6 | 37 It is the largest hospital in this city called Huntsville hospital. The
doctor says the biopsy will be done after the surgery. 马上就要手术了。希望
手术成功。上帝保佑不是恶性的。她还非常年轻，连25岁都不到，而且平时什么症状都
没有。希望您能继续给建议。 |
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l*h
发帖数: 4124 | 38 mycosis fungoides is not as rare as previously thought. the incidence was
thought to be 3-4 per million, but in recently years there have been a lot
more patients.
if the rashes appear relative fast in large patches and multiple areas, it
should be suspected as the skin presentation of Sezary syndrome. Sezary
syndrome is a related cutaneous T-cell lymphoma with worse prognosis.
early bone marrow puncture or biopsy is NOT recommended (as a matter of fact
, strongly discouraged).
early tests shoul... 阅读全帖 |
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d******q
发帖数: 239 | 39 OK, I've certainly seen the different opinions on the BBS and I appreciate
all the input from different parties. I presented the case here is to get
myself informed; sometimes it's difficult to make a decision coz I'm not a
medical professional. That being said, I understand that the major source
for my family to make treatment decisions is still the suggestions from her
doctors.
Indeed, her onset was quite aggressive, except face, patches and plaques
were present in all other parts, but no lesi... 阅读全帖 |
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l*h
发帖数: 4124 | 40 OK, let's make it simpler:
when did her fever start? when did it end?
when was the PET-CT done?
when was the sample taken for the bone marrow biopsy report written on 11/2/
2012? |
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w****r
发帖数: 212 | 41 Please see my answers below:
when did her fever start? when did it end?
10-13 start, high fever ended on 10-30, since then till 11-19 had low fever
< 38. After 11-19, no fever at all.
when was the PET-CT done?
was done on10-31
when was the sample taken for the bone marrow biopsy report written on 11/2/
was taken on 10-24,
2/ |
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a**********2
发帖数: 3726 | 42 Hard to say. The diagnosis of bone tumor is sometimes very tough to make. X
ray, bone scan, only provides possibility, even pathology (biopsy) sometimes
can not confirm the diagnosis.
Lets say if it is, with current 2 year of survival without obvious
metastasis or local invasion, it sounds benign or low grade malignancy.
As for the anti inflammatory meds (NSAIDS), it helps for some patients
Or early stage of pain management, but you can't judge that it is not bone
tumor because the pain can be c... 阅读全帖 |
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a**********2
发帖数: 3726 | 43 Urologists.
No, most likely tests and biopsy will have to be repeated.
It's not an emergent surgery, so no need to rush. |
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a**********2
发帖数: 3726 | 44 His age and biopsy consistent with glioblastoma. The chance of misdiagnosis
is extremely low. So better not have false hope and early surgery is the
key if possible. If no surgery indication, then radiation therapy for
symptom relief and then palliative care. Absolutely not come to the US. |
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a**********2
发帖数: 3726 | 45 I am sorry for this unfortunate girl. It is a very rare disease, I have
never seen such patients and I believe probably very few physicians have
experience On this disease. Here is what I have known from literature review
and hopefully it helps. To make it short,I will go straight to the point.
1. It usually is a multi system disease in a child younger than 3, and a
single system disease in adults and older children. So I assume she has a
multi system disease.
2. Per recommendation, prior to tr... 阅读全帖 |
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a**********2
发帖数: 3726 | 46 sometimes primary doctor will tell you, sometimes they dont, although they
should. CT scan with contrast is the definite diagnosis. No need to do
biopsy. |
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a**********2
发帖数: 3726 | 47 Why not get diagnosed? Sounds like she had colonoscopy, she also had surgery
, biopsy should be done from both, so diagnosis should be there. Confused. |
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a**********2
发帖数: 3726 | 48 I am confused. What is the real diagnosis? Crohn or eosinophilic? By biopsy
from colonoscopy and surgery, it should not be so equivocal. |
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l******e
发帖数: 1875 | 49 前面发帖问过有医院只开局部乳腺B超，我不放心，另外找了radiologist开的私人诊所
做了两个全乳B超。
做完后两家医院的结论截然相反，很意外。第一家医院查出的可疑的病变的图像显示几
个紧密邻近的偏暗区边界不清楚，当时医院很肯定告诉我不是simple cysts，需要先分
别做aspiration，不行的话还得needle biopsy。这个问题被发现我倒不意外，因为其
实在几年前国内几家医院检查也基本被定为边界不清楚，有少许血流信号，偏实质性结
节，恶性可疑，需要穿刺检查。平时偶尔有痛感，和月经周期没有关系地发作。
但现在第二家私人诊所觉得该问题没有恶性的可能（他们解释是因为他们机器更高档，
是ultrasound exams with shear wave elastography，，显示那个可疑的地方是液性
的，认为是囊肿）。。机器不同可以有这么神奇的变化么？这种还需要另外找医院看看
不同意见么？
另外目前的诊所在前一家医院没有检查的一个部位发现了新的可疑的问题（是一个边界
很清晰的实质性肿块，中间有少许血流信号，高度怀疑是纤维腺瘤，他们觉得可以继续
观察，但同时也建议我最好... 阅读全帖 |
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g*****n
发帖数: 21 | 50 今天去看了骨科医生，他说绝大部分情况是内生软骨瘤，但是要确诊的话就要做手术植
骨。因为现在我无疼痛感，也没其他异样，可以先观察三个月，再看看这个瘤有无增长
。他这个说法靠谱吗？
谢谢！
IV |
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