l****s
发帖数: 161 | 1 本人海归不到半年（32岁，未婚，有绿卡），11月底感冒后发现颈部淋巴肿大，就医几
次之后都以为是良性的淋巴增生，尝试吃消结的中成药，还有头孢克肟胶囊未见消退，
就在过年后去了复旦大学附属的肿瘤医院做了穿刺检查和血细胞簇分化抗原（CD）系列
检测，结果还是未能确诊，病理诊断为 倾向恶性淋巴瘤（见附件）。因为拿报告的时
候比较晚，门诊已经关门，就问了下做检测的医生，说60-70%可能是恶性淋巴瘤，建议
我做病理切片来最终确诊（会留疤），考虑到美国这边医疗技术可能好些，就想可不可
以直接来美国来检查确诊。请问美国这边的病理切片和国内的病理切片一样会留很明显
的疤痕吗？会不会小些，还有就是在美国有没可能用其他更先进的方式不用病理切片就
能确诊呢？ 俯首叩谢！
另外，本人在美国没有保险，要是真到美治疗的话，保险可以现买吗？ |
m****u
发帖数: 275 | 2 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 | 3 what is cd30+ t cell lymphoma? is this curable? or is the survival chance
high?
many thanks!
may
【在 m****u 的大作中提到】
: 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*h
发帖数: 4124 | 4 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.
【在 l****s 的大作中提到】
: 本人海归不到半年（32岁，未婚，有绿卡），11月底感冒后发现颈部淋巴肿大，就医几
: 次之后都以为是良性的淋巴增生，尝试吃消结的中成药，还有头孢克肟胶囊未见消退，
: 就在过年后去了复旦大学附属的肿瘤医院做了穿刺检查和血细胞簇分化抗原（CD）系列
: 检测，结果还是未能确诊，病理诊断为 倾向恶性淋巴瘤（见附件）。因为拿报告的时
: 候比较晚，门诊已经关门，就问了下做检测的医生，说60-70%可能是恶性淋巴瘤，建议
: 我做病理切片来最终确诊（会留疤），考虑到美国这边医疗技术可能好些，就想可不可
: 以直接来美国来检查确诊。请问美国这边的病理切片和国内的病理切片一样会留很明显
: 的疤痕吗？会不会小些，还有就是在美国有没可能用其他更先进的方式不用病理切片就
: 能确诊呢？ 俯首叩谢！
: 另外，本人在美国没有保险，要是真到美治疗的话，保险可以现买吗？
|
m****u
发帖数: 275 | 5 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 excisional biopsy for
definitive diagnosis and immediate treatment.
【在 l****s 的大作中提到】
: what is cd30+ t cell lymphoma? is this curable? or is the survival chance
: high?
: many thanks!
:
: may
|
l****s
发帖数: 161 | 6 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
【在 m****u 的大作中提到】
: 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 excisional biopsy for
: definitive diagnosis and immediate treatment.
|
l****s
发帖数: 161 | 7 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
【在 l*h 的大作中提到】
: 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.
|
f****o
发帖数: 2770 | 8 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
【在 l****s 的大作中提到】
: 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
|
m*******u
发帖数: 6052 | 9 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 | 10 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 | 11 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 those CD30+ cells are
T cells. Anyway, it seems to me Fudan medical center is totally incompetent
in reporting flow cytomtry. I am very surprised to see this.
【在 B*********n 的大作中提到】
: 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。
|
l****s
发帖数: 161 | 12 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
【在 m****u 的大作中提到】
: 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 those CD30+ cells are
: T cells. Anyway, it seems to me Fudan medical center is totally incompetent
: in reporting flow cytomtry. I am very surprised to see this.
|
m****u
发帖数: 275 | 13 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.
【在 l****s 的大作中提到】
: 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
|
w******i
发帖数: 1899 | 14 我皮肤T细胞淋巴瘤，挺了快一年了。
LMH给了不少鼓励和建议 |
l*h
发帖数: 4124 | 15 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.
【在 l****s 的大作中提到】
: 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
|
l*h
发帖数: 4124 | 16 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
【在 m*******u 的大作中提到】
: 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。
|
l*h
发帖数: 4124 | 17 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
【在 m****u 的大作中提到】
: 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 those CD30+ cells are
: T cells. Anyway, it seems to me Fudan medical center is totally incompetent
: in reporting flow cytomtry. I am very surprised to see this.
|
l****s
发帖数: 161 | 18 做了PET，体内也有肿瘤，基本能确定是淋巴瘤了，后来也问了那个给我做检测的医生
，说是Hodgkin's lymphoma的可能性大些，结合上面medstu说的，这一型的可能还是挺
大的，正在尽快预约做活检做最后确诊看是哪一型。
另外，在网上看到了一个治疗这个的新药sgn-35，貌似只有美国有，而且好像只针对复
发病人，请问这个可以给初次治疗的患者用吗？效果比传统的方法好多少呢？
60
【在 l*h 的大作中提到】
: 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
|
f****o
发帖数: 2770 | 19 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
【在 l****s 的大作中提到】
: 做了PET，体内也有肿瘤，基本能确定是淋巴瘤了，后来也问了那个给我做检测的医生
: ，说是Hodgkin's lymphoma的可能性大些，结合上面medstu说的，这一型的可能还是挺
: 大的，正在尽快预约做活检做最后确诊看是哪一型。
: 另外，在网上看到了一个治疗这个的新药sgn-35，貌似只有美国有，而且好像只针对复
: 发病人，请问这个可以给初次治疗的患者用吗？效果比传统的方法好多少呢？
:
: 60
|
l*h
发帖数: 4124 | 20 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.
【在 l****s 的大作中提到】
: 做了PET，体内也有肿瘤，基本能确定是淋巴瘤了，后来也问了那个给我做检测的医生
: ，说是Hodgkin's lymphoma的可能性大些，结合上面medstu说的，这一型的可能还是挺
: 大的，正在尽快预约做活检做最后确诊看是哪一型。
: 另外，在网上看到了一个治疗这个的新药sgn-35，貌似只有美国有，而且好像只针对复
: 发病人，请问这个可以给初次治疗的患者用吗？效果比传统的方法好多少呢？
:
: 60
|
|
|
b*****1
发帖数: 1731 | 21 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
【在 m****u 的大作中提到】
: 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 excisional biopsy for
: definitive diagnosis and immediate treatment.
|
A*****a
发帖数: 52743 | 22 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
,
【在 b*****1 的大作中提到】
: 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
|
b*****1
发帖数: 1731 | 23 是是，心里作用，谢谢专家！
【在 A*****a 的大作中提到】
: 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 | 24 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
【在 l****s 的大作中提到】
: 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
|
m**********r
发帖数: 2099 | 25 request excisional biopsy, just say the condition has made you crazy
查。
【在 b*****1 的大作中提到】
: 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
|
j****d
发帖数: 123 | 26 You can also request PET scan, but your insurance may not agree. I think PET
has >80% accuracy on solid malignancies
【在 b*****1 的大作中提到】
: 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
|
