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m*i
发帖数: 24 | 1 孩子一岁十个月，女孩，身高84，体重23斤。
病理诊断：
（下颌骨）朗格汉斯细胞组织细胞增生症（Langerhans Histocytosis）。
请结合专科检查除外Letterer－Siwe病。免疫组化染色显示：瘤细胞CDla（＋），CD68
（＋），Ki－67（＋20％），
S—100（＋）。
小女孩人在北京，家庭条件也不允许来美国治疗。
因为父母希望孩子在化疗放疗之后能够有正常的生活，能够长大。
希望能够得到有经验的医生提供美国化疗用的药量。
谢谢 | l*h
发帖数: 4124 | 2 as always for those experts in China, the author of the report miraculously
reached a conclusion, then said "another disease" should be ruled out. the
truth is that the two names are for the same disease. when his knowledge and
approach are so fundamentally flawed, his report is NOT to be trusted.
CD68
【在 m*i 的大作中提到】
: 孩子一岁十个月，女孩，身高84，体重23斤。
: 病理诊断：
: （下颌骨）朗格汉斯细胞组织细胞增生症（Langerhans Histocytosis）。
: 请结合专科检查除外Letterer－Siwe病。免疫组化染色显示：瘤细胞CDla（＋），CD68
: （＋），Ki－67（＋20％），
: S—100（＋）。
: 小女孩人在北京，家庭条件也不允许来美国治疗。
: 因为父母希望孩子在化疗放疗之后能够有正常的生活，能够长大。
: 希望能够得到有经验的医生提供美国化疗用的药量。
: 谢谢
| l*h
发帖数: 4124 | 3 let me clarify a little bit.
Letterer-Siwe was first described close to a hundred years ago. the use of "
Letterer－Siwe" has changed several times over the time. at this time, most
physicians use it to describe a certain clinical presentation of Langerhans
cell histiocytosis (ie. infantile multifocal multisystem type ). but some
use it as a synonym of Langerhans cell histiocytosis.
first, the diagnosis of Langerhans cell histiocytosis must be confirmed.
assuming it is the correct diagnosis,
second, it should be classified as either monocyte/macrophage type or
dendritic cell type. CD68 is a marker on mono/macrophage but the report didn
't describe the staining pattern or the percentage of cells stained, and no
dendritic cell markers were used. kind of defeating the purpose of
immunotyping.
third, she should be evaluated for the extent of the disease: unifocal,
multifocal unisystem or multifocal multisystem.
for treatment, before 3 full years old, radiation therapy should be avoided
if possible at all. the main treatment is steroids and chemotherapy. if
radiation therapy cannot be avoided before 3 full years old, radiation of
the central nervous system and epiphyseal plates of the bones should be
avoided. |
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