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l**********s
发帖数: 255 | 1 前一段发过关于国内朋友家人的脂膜炎的问题， lmh 曾经给过回复， 在此谢过。
附件是他的病历，60多岁，男，没有其他疾病。
我的朋友说国内很多医院都去过了， 最后只能吃激素来控制，希望看看美国这边有什
么最新的方法。我也帮他查了一些医学论文，隔行如隔山确实看不太懂，貌似也是说要
吃激素。
lmh 曾说过不像是脂膜炎，不知道能不能再指点下。 谢谢。 | l*h
发帖数: 4124 | 2 panniculitis is a collection of many diseases. the common feature is that
the primary pathological changes are in the adipose tissue, not the fibrous
tissue. this is why the pathology report is not consistent with panniculitis.
this could be a poor tissue sampling. panniculitis cannot be ruled out.
if panniculitis is diagnosed, it should also indicate the type or cause:
infectious, traumatic or secondary/as part of another disease. they are all
very different.
things against panniculitis: the pathology report, 表皮不红
things for panniculitis: subcutaneous nodules
if it responds fast to antibiotics, it argues for an infectious cause (could
be infectious panniculitis or cellulitis cause by low virilence bacteria.)
other part of the description doesn't give much indication what it could be:
both infectious and autoimmune processes could present with that pattern (
fever, fatigue etc.)
the diagnosis will depend on a good pathology study (including a proper
tissue sampling). if pathology is consistent with panniculitis, then
determine the type or cause.
【在 l**********s 的大作中提到】
: 前一段发过关于国内朋友家人的脂膜炎的问题， lmh 曾经给过回复， 在此谢过。
: 附件是他的病历，60多岁，男，没有其他疾病。
: 我的朋友说国内很多医院都去过了， 最后只能吃激素来控制，希望看看美国这边有什
: 么最新的方法。我也帮他查了一些医学论文，隔行如隔山确实看不太懂，貌似也是说要
: 吃激素。
: lmh 曾说过不像是脂膜炎，不知道能不能再指点下。 谢谢。
| l*h
发帖数: 4124 | 3 the pathology report didn't give a detailed description of those
inflammatory cells. but both acute and chronic were present, arguing for
infectious causes. some low virulence bacteria can take a long time to be
diagnosed.
【在 l**********s 的大作中提到】
: 前一段发过关于国内朋友家人的脂膜炎的问题， lmh 曾经给过回复， 在此谢过。
: 附件是他的病历，60多岁，男，没有其他疾病。
: 我的朋友说国内很多医院都去过了， 最后只能吃激素来控制，希望看看美国这边有什
: 么最新的方法。我也帮他查了一些医学论文，隔行如隔山确实看不太懂，貌似也是说要
: 吃激素。
: lmh 曾说过不像是脂膜炎，不知道能不能再指点下。 谢谢。
| l**********s
发帖数: 255 | 4 替我的朋友感谢lmh的耐心回复！
请教一下a proper tissue sampling和a poor tissue sampling分别是什么？谢谢．
fibrous
panniculitis.
all
could
【在 l*h 的大作中提到】
: panniculitis is a collection of many diseases. the common feature is that
: the primary pathological changes are in the adipose tissue, not the fibrous
: tissue. this is why the pathology report is not consistent with panniculitis.
: this could be a poor tissue sampling. panniculitis cannot be ruled out.
: if panniculitis is diagnosed, it should also indicate the type or cause:
: infectious, traumatic or secondary/as part of another disease. they are all
: very different.
: things against panniculitis: the pathology report, 表皮不红
: things for panniculitis: subcutaneous nodules
: if it responds fast to antibiotics, it argues for an infectious cause (could
| l*h
发帖数: 4124 | 5 i was talking about biopsy.
he probably needs a surgical biopsy, not a core/needle biopsy. open surgical
biopsy will give you sufficient tissue. core/needle biopsy often not.
【在 l**********s 的大作中提到】
: 替我的朋友感谢lmh的耐心回复！
: 请教一下a proper tissue sampling和a poor tissue sampling分别是什么？谢谢．
:
: fibrous
: panniculitis.
: all
: could
| l**********s
发帖数: 255 | |
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