l*****e
发帖数: 594 | 1 【 以下文字转载自 MedicalCareer 讨论区 】
发信人: logocde (logo), 信区: MedicalCareer
标 题: 妻子病理报告疑似 MALT Lymphoma, 心里一团麻，请问报告的准确性
发信站: BBS 未名空间站 (Thu May 26 03:47:25 2016, 美东)
妻子刚过了34岁生日，家里一个3岁一个1岁娃。接到大夫电话自己都傻了，到现在不是
很相信，恳请版上热心的朋友帮忙看看这个确定的概率有多大，感激不尽。另外如果有
好的南加地区的 ONCOLOGIEST 也恳请推荐。
大致情况是去年初生了老二之后，在月子里有一天吃了朋友送的酒酿之后当日小腹疼，
拉稀，之后断断续续一直这样时好时坏。因为哺乳所以没吃药。后来家里给寄了一些叫
“思密达”的粉状药说可以缓解症状吃了很多。到去年入秋突然有一晚胃疼的直不起腰
，去看了primary physician，作了血检，什么也没查出来，而且到了那就不那么疼了
，给refer了GI specialist,也没说什么就说要注意饮食。今年3月初又一次疼痛难忍，
去了PRIMARY ，给吃了药没好，又打了一止疼针才慢慢好点，再次约了GI SPECIALIST
，给约了肠镜和胃镜。五月初作的时候发现肠内有息肉，切除了送去作病例。早上妻子
接到电话说晚上大夫会给我们打电话，并且叮嘱我也一定在场，我就觉得不好。刚才好
容易把老大哄睡了，这会自己乱七八糟的GOOGLE 半天，感觉好像基本靠谱，但是不太
死心，毕竟什么都是有概率的，所以发到这里请懂的朋友帮忙看看。先谢谢大家帮忙！
2, 3. Terminal ileum and ileocecal valve polyp, biopsies:
LOW-GRADE LYMPHOPLASMACYTIC NEOPLASM, FAVOR EXTRANODAL
MARGINAL ZONE LYMPHOMA (MALT LYMPHOMA) WITH PLASMACYTIC
DIFFERENTIATION AND AMYLOID DEPOSITION, SEE COMMENT.
IMMUNOPHENOTYPE (IMMUNOHISTOCHEMISTRY):
- B LYMPHOCYTES:
POSITIVE FOR: PAX5, CD20, BCL2.
NEGATIVE FOR CD5, CD10, CYCLIN D1.
- PLASMA CELLS:
POSITIVE FOR CD138, CD10, BCL2, KAPPA LIGHT CHAIN.
NEGATIVE FOR CD56, CYCLIN D1,
Ki67 PROLIFERATIVE INDEX: 5%.
COMMENT: There is an abnormal expansion of small mature B cells,
consistent with a low-grade B-cell lymphoma (MALT lymphoma). In
addition, there is a prominent monoclonal plasmacytic component and
associated amyloid deposition.
Extramedullary plasmacytoma is also a consideration, but is less
favored due to the abnormal expansion of B cells and the lack of
cyclin D1 and CD56 in plasma cells. Recommend SPEP/IFE studies to
look for a serum paraprotein.
Amyloid deposition associated with MALT lymphoma is uncommon. See
reference below for a recent case series.
Ryan et al. (2012). Extranodal marginal zone lymphoma of mucosa-
associated lymphoid tissue with amyloid deposition. Am J Clin Pathol
137; 51-64. | M****0
发帖数: 877 | 2 First, don't be panic. This is a type of low grade lymphoma and usually it
has a pretty indolent clinical course, which is supported by low Ki67
percentage.
Second, what is the H pylori test result? If positive, treatment of the H
pylori infection could relieve her symptoms and even cure this disease.
It would be better to discuss with an oncologist, as it may need a little
more work up to do.
Don't have too much time at this moment to explain. But totally understand
your mood. Best luck, | l*****e
发帖数: 594 | 3 H-polori 是negative，作胃镜时候作了biopsy.
请问 ki67 具体是如何参考？google到一些但是不是很明确。非常感谢回复！
正在约oncologist, 是不是应该约comprehensive cancer center 的大夫好些？目前在
一家综合medical center Sharp.
【在 M****0 的大作中提到】
: First, don't be panic. This is a type of low grade lymphoma and usually it
: has a pretty indolent clinical course, which is supported by low Ki67
: percentage.
: Second, what is the H pylori test result? If positive, treatment of the H
: pylori infection could relieve her symptoms and even cure this disease.
: It would be better to discuss with an oncologist, as it may need a little
: more work up to do.
: Don't have too much time at this moment to explain. But totally understand
: your mood. Best luck,
| Z******u
发帖数: 19 | |
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