m**********r
发帖数: 2099 | 1 你好！
血常规，如果英语是CBC那么如果是淋巴瘤、白血病可以发现。伴有贫血的肿瘤，可
以对肿瘤诊断有帮助。这个就像汽车换机油不能查出是否三元催化有没有毛病一样。 |
|
j*******3
发帖数: 940 | 2 朋友的老公，年纪轻轻，查出来淋巴癌，对他们来说是很大的打击。说是纵隔大B细胞
淋巴瘤中期。
朋友想问一下美国这边对这个病有什么治疗方法，效果怎么样？
请xdjm们帮忙。 感激不尽！ |
|
m**g
发帖数: 50 | 3 初生儿淋巴管瘤和淋巴癌是完全不一样的.淋巴管瘤是胎儿在肚子里淋巴系统没有发育
完整造成的.打个比方,淋巴管就像是很多大路小路,本来该完全连在一起,但如果没有发
育好,就会有一些dead end。于是淋巴液不断积累，形成囊肿。这不是细胞癌变，所以
在美国不被看作恶性的。楼主可以google "lymphantic malformation", or "
Lymphangioma" or "cystic hygroma".不过这个病可能会和别的混在一起，尤其在国内
，碰到囊肿第一方案就是手术。确诊的方法很简单，只要取出囊肿里面液体分析，如果
是淋巴液，就是了。
因为不是癌变，美国的医生并不觉得这个病是一定要早治的，除非影响孩子的发育。有
些淋巴瘤是一个或两个大的淋巴泡，有些是很多小的淋巴泡，所以可能是micro cyst
or macro cyst. Macro看起来很大，但是治疗其实容易，用sclero therapy,伤害小。
Micro很难完全治，一般需要手术。治疗的本质就是要完全去除囊肿淋巴壁。如果只是
部分去除，会重新长合，重新积液形成囊肿。所以手术割除不一定是最好。
美国有两个... 阅读全帖 |
|
f****o
发帖数: 2770 | 4 这个你要赶快治疗啊
国内不能治么
等你来米国会不会耽误啊 |
|
|
l*h
发帖数: 4124 | 6 1. no US-based physicians would ever trust such a pathology report. it's
really shameful that even the "best" hospitals in China write pathology
report this way. in the 90s and early 2000s, some top teaching hospitals
would still write the reports in the acceptable way.
2. it seems the report was written in 2013. if the diagnosis is correct and
no definitive treatment has been given since, it's really unfortunate for
the kid. it means life or death.
3. why no treatment can be done in China? it s... 阅读全帖 |
|
w******o
发帖数: 56 | 7
★ 发自iPhone App: ChineseWeb 8.6 |
|
w******o
发帖数: 56 | 8 真不好意思，用手机app发了空信都不知道! 是去年年底发现的，现已在上海一家医院
做了一期化疗，但效果不佳想转院却苦于没有其它医院接收
and
radiation. |
|
l*h
发帖数: 4124 | 9 if the diagnosis was mainly based on the pathology "report," the status of
this case should be considered "not diagnosed" yet.
no physician in their right mind should trust a diagnostic report that does
not present evidence. |
|
w******o
发帖数: 56 | 10
★ 发自iPhone App: ChineseWeb 8.6 |
|
w******o
发帖数: 56 | 11
★ 发自iPhone App: ChineseWeb 8.6 |
|
w******o
发帖数: 56 | 12
★ 发自iPhone App: ChineseWeb 8.6 |
|
w******o
发帖数: 56 | 13 以下是诊断报告
★ 发自iPhone App: ChineseWeb 8.6 |
|
w******o
发帖数: 56 | 14
★ 发自iPhone App: ChineseWeb 8.6 |
|
w******o
发帖数: 56 | 15
★ 发自iPhone App: ChineseWeb 8.6 |
|
w******o
发帖数: 56 | 16
★ 发自iPhone App: ChineseWeb 8.6 |
|
v**o
发帖数: 4956 | 17 家里很有钱么？至少卖掉一两个房产单元
上海市民全民医保，上海的医疗平均水平超过美国平均 |
|
l*h
发帖数: 4124 | 18 what is his doctor's plan of diagnosis and treatment?
this is very high stake for the patient. the pathologists need to present
morphological, cytogenetics and immunophenotyping evidence to support their
opinion. the hem/onc need to present evidence for staging, and their
philosophy for management.
no matter where you seek consultation, you need to present information
properly.
i am in more and more despair about the medical profession in China. the kid
has already been seen in the "best" hospit... 阅读全帖 |
|
m****u
发帖数: 275 | 19 You likely have a CD30+ T cell lymhoma. The flow cytometry was not read
properly. I would recommend you to have a biopsy with flow cytometry and
histology done asap. Its better to have it done in the USA but insurance may
be a problem since the diagnostic fees alone will be in the thousands. Go
to a better hospital in China. |
|
l****s
发帖数: 161 | 20 what is cd30+ t cell lymphoma? is this curable? or is the survival chance
high?
many thanks!
may |
|
l*h
发帖数: 4124 | 21 these are the same "pathologists" as in:
http://www.mitbbs.com/article_t/Medicine/31273685.html
where did they present morphological evidence to support their opinion? how
did they choose the immunophenotyping panel? the panel was reported in a way
you cannot see the list of what were included. |
|
m****u
发帖数: 275 | 22 I am a hematopathologist. The flow cytometry report was incomplete. I was
surprised how low-profile Fudan medical center is. However, based on the
information you pasted, you likely have a CD30+ T cell lymphoma or Hodgkin'
s lymphoma. I would suggest you seek a biopsy of the lymph node for
definitive diagnosis. Lymphoma is hematologic malignancy. Once diagnosed,
you will receive chemotherapy. The prognosis will depend on the lymphoma
type and staging. Do not waste time here, go to get an excisi... 阅读全帖 |
|
l****s
发帖数: 161 | 23 非常感谢您提供的信息，请问像我这种情况如果去美国诊治有没有什么临时的保险可以
买呢？
Hodgkin'
for |
|
l****s
发帖数: 161 | 24 请问我这种情况有必要去美国诊治吗？
如果是的话，我美国没有医保，有临时的可以申请吗？
感谢 感谢
how
way |
|
f****o
发帖数: 2770 | 25 赶快国内开始化疗吧
你觉得美国保险工公司傻到让一个外国人买保险然后用来治疗癌症么？ pre existing
condition不保
亏本买卖不会做的 |
|
m*******u
发帖数: 6052 | 26 找个国内三甲医院做，很快，不会花很多钱。
如果需要化疗，化几次歇一歇，可以配合中药治疗
没有必要专门到美国来治，因为在治淋巴癌这方面，国内外技术差不多（但是价钱差了
不是一星半点）。
楼主不要紧张，要休息好，提高免疫能力，我嫂子四年前诊断淋巴癌，除了第一年集中
化疗了6次，以后每年2次，配合中药，现在状况良好。 |
|
B*********n
发帖数: 368 | 27 奇怪，做了穿刺， 应该就可以确诊了， 为什么确诊不了？ 我家里有人就是穿刺确诊
的。 |
|
m****u
发帖数: 275 | 28 It depends on the type of lymphoma and the expertise of the pathologists.
The flow cytometry report lz posted is apparently incomplete and the person
who reported it was not competent. At least the person could have looked at
whether pan-T cell antigens are decreased or increased instead of reporting
them as + or -, which is not very helpful. The CD4/CD8 is 117, that's very
abnormal, whey did they not look into it? If they saw 12% of cells
expressing CD30, they should go further to see whether t... 阅读全帖 |
|
l****s
发帖数: 161 | 29 我后天去华山医院做pet，不知道这个做了是不是就能确诊了
person
at
reporting
are
incompetent |
|
m****u
发帖数: 275 | 30 Pet is an imaging study. It will tell you whether you have other swollen
lymph nodes or mediastinum. It will not diagnose lymphoma. You still need a
biopsy. |
|
l*h
发帖数: 4124 | 31 hope you find a properly trained hematologist who works with a properly
trained hematopathologist. no need to be fancy, just properly trained.
if possible, you might want to have your slides reviewed by
hematopathologists in the US. but it is usually extremely difficult to
borrow slides from hospitals in China. most of them, even those with whole
slide scanners, don't want to give you any images. the same goes for
radiology. it is extremely difficult to get dicom files from hospitals in
China. |
|
l*h
发帖数: 4124 | 32 医学教育用不着收什么高中生初中生，高小毕业学三年就够了。华佗读的是几年制？明
朝的李时珍读的是几年制？
--毛泽东 |
|
l*h
发帖数: 4124 | 33 the reason is simple. systematic medical training was abolished more than 60
years ago in China. all the "top" hospitals in China look like this. 301,
Fuwai, Tiantan, Beijing, People's and etc. are NOT better than Fudan.
医学教育用不着收什么高中生初中生，高小毕业学三年就够了。华佗读的是几年制？明
朝的李时珍读的是几年制？
--毛泽东
person
at
reporting
are
incompetent |
|
f****o
发帖数: 2770 | 34 brentuximab 就是给relapsed的病人用的
你刚确诊就要按照guideline一线疗法开始 |
|
l*h
发帖数: 4124 | 35 find some good doctors to take care of you. also read some patient eduction
material, ask your doctors all the questions you may have.
NCI website provides a lot of good information for cancer patients; WebMD is
also a good patient education website. |
|
b*****1
发帖数: 1731 | 36 我也问专家一个问题，我去年在美国x光和B超查出乳房有个小肿块，我自己感觉不到，
因为当时还给孩子喂奶，查出就不喂奶了，可是也没有消，医生诊断良性，我不放心，
因为我母亲快66岁的时候乳腺癌去世，在国内小医院误诊了。我很害怕就约专科医生切
除肿块，医生再三说不是癌，没有必要切除，说实在不放心就做个穿刺，needle
biopsy结果也是良性，看的医生都要求半年观察变化，如果不变化就改成一年一次检查。
你说医生为什么不给切除，还有这检查可靠么，因为一个肿块，要是取的位置不好，那
也不可靠呀。
Hodgkin'
for |
|
A*****a
发帖数: 52743 | 37 你不能迷信手术切除。如果担心穿刺不准，你也该担心切除不净。手术是创伤疗法，不
得已的时候才会做，任何手术都有感染的风险，破坏正常组织的风险。
查。
was
, |
|
|
b*****1
发帖数: 1731 | 39 不是有奥八马care,不是有人生孩子就可以申请，你这样有绿卡的应该可以吧。
obamacare |
|
m**********r
发帖数: 2099 | 40 request excisional biopsy, just say the condition has made you crazy
查。 |
|
j****d
发帖数: 123 | 41 You can also request PET scan, but your insurance may not agree. I think PET
has >80% accuracy on solid malignancies |
|
l*h
发帖数: 4124 | 42 it appears there was GvHD, and now host vs graft.
rituximab is against B-cells, not T-cells. its use in rejection treatment is
off-label and efficacy is not well documented.
you might want to do a chimerism test at next bone marrow aspiration. it may
provide clues how to further treat her. |
|
m********r
发帖数: 259 | 43 非常感谢lmh的建议。很有帮助。我已经转达我姐夫了。他会立即跟主管医生提议是不
是要再次做一个嵌合体检测，以决定下一步治疗方案。
再次表示感谢！ |
|
l*h
发帖数: 4124 | 44 do chimerism testing on both marrow and peripheral blood.
this can be easily done by staining sex chromosomes because the donor and
recipient are of different sex. |
|
m********r
发帖数: 259 | 45 Thank you again, lmh!
This is a very helpful suggestion with valuable details. I have forward this
suggestion to my Brother-in-law.
Deeply appreciate your help!
Chen |
|
d********h
发帖数: 2048 | 46 淋巴瘤（NHL-4) 有什么推荐医院吗？美国，中国都行。谢谢 |
|
g*******4
发帖数: 371 | 47 紧急求助：病人以昏迷，并上呼吸机中。
四月前无明显诱因出现左侧头部间断性抽痛，左侧面部麻木，无发热，未在意。三月前
出现发热，37-38度，站立及行走不稳，左下肢无力，走路拖曳，反应迟钝，应用头孢
类抗生素无效，治疗当晚出现嗜睡，问话不答，第二天出现意识不清，伴有发热，咳嗽
，咳痰，急诊入院后以脑炎收入，予以甲基强的松龙1500mg冲击治疗+万古霉素+头孢米
诺，第二天神志好转为嗜睡，激素每5天逐渐减量，“右侧肢体肌力3级，左侧肢体肌力
4级”。治疗20天后神志转清，问答基本切题，治疗过程中出现左上肢无力，不能持重
物。两月前出院，出院时“体温正常，左侧肢体肌力4级，右侧肢体肌力5级”，回家后
继续营养神经治疗，激素停药后，1月半前再次出现左上肢无力较前加重，不能抬起，
左下肢无力，行走不稳，睡眠时间增多，1月前出现嗜睡，食量减少，大，小便需家属
帮助，体重减轻5kg。再次以脑炎入院。入院后给予甲基强的松龙1000mg冲击治疗+注射
用人免疫球带白10g (5天)，头孢曲松钠他睉巴坦钠抗炎。治疗后患者仍神志昏睡，进
食量减少，大小便正常，体温37.2度，强刺激可醒，问话不能回答，对光反... 阅读全帖 |
|
d********h
发帖数: 2048 | 48 淋巴瘤（NHL-4) 有什么推荐医院吗？美国，中国都行。谢谢 |
|
g*******4
发帖数: 371 | 49 紧急求助：病人以昏迷，并上呼吸机中。
四月前无明显诱因出现左侧头部间断性抽痛，左侧面部麻木，无发热，未在意。三月前
出现发热，37-38度，站立及行走不稳，左下肢无力，走路拖曳，反应迟钝，应用头孢
类抗生素无效，治疗当晚出现嗜睡，问话不答，第二天出现意识不清，伴有发热，咳嗽
，咳痰，急诊入院后以脑炎收入，予以甲基强的松龙1500mg冲击治疗+万古霉素+头孢米
诺，第二天神志好转为嗜睡，激素每5天逐渐减量，“右侧肢体肌力3级，左侧肢体肌力
4级”。治疗20天后神志转清，问答基本切题，治疗过程中出现左上肢无力，不能持重
物。两月前出院，出院时“体温正常，左侧肢体肌力4级，右侧肢体肌力5级”，回家后
继续营养神经治疗，激素停药后，1月半前再次出现左上肢无力较前加重，不能抬起，
左下肢无力，行走不稳，睡眠时间增多，1月前出现嗜睡，食量减少，大，小便需家属
帮助，体重减轻5kg。再次以脑炎入院。入院后给予甲基强的松龙1000mg冲击治疗+注射
用人免疫球带白10g (5天)，头孢曲松钠他睉巴坦钠抗炎。治疗后患者仍神志昏睡，进
食量减少，大小便正常，体温37.2度，强刺激可醒，问话不能回答，对光反... 阅读全帖 |
|
H*********i
发帖数: 1 | 50 新建账户发帖求建议。 先谢了！！！
国内70岁老人前年2013底， 2014初因大腿根部淋巴结肿大在天津肿瘤医院被诊断为黑
色素瘤3期。手术切除淋巴瘤后在2014年上半年进行化疗。化疗之后只是休养，未继续
任何药物治疗，从6月至今完成3次复诊。患者老人目前精神状态良好。就复查结果而言
，虽然，医生也讲到还不算是已转移， 但也郑重提示恶黑（恶性黑色素瘤）的危险。
对于后续如何医疗/休养，目前家属尚有多许担心。希望有医界专家和患者家属们能对
病情诊断结果做个通俗解释并赐于宝贵建议。以下是化疗后的三次复查结果。敬请专家
学者辅以宝贵建议。
1:最近2015年1月的诊断。CT 和超声（化疗后第三次复查）
临床诊断：左侧腹股沟淋巴结转移性恶性黑色素瘤
检查项目：胸部CT平扫（普+特）
影像表现：两肺胸膜下可见散在小栗粒结节影。双肺散在条索影。双肺门不大。各支气
管开口通畅。双锁上，纵隔内及双腋下多发小淋巴结。双侧胸膜稍厚， 心包腔及双侧
胸腔未见积液。所见肝脏多发低密度结节，部分边界欠清。
超声， 诊断内容：
双侧腹股沟扫查： 双侧腹股沟未见明显肿大及异常回声淋巴结影。
肝，胆，... 阅读全帖 |
|
