s********e
发帖数: 136 | 1 我爸爸X光检查出有阴影，
CT检查如下：
CT所见：右上肺见索条状密度影。右肺下叶背段见一小结节影，边缘欠光整。两肺门
区未见异常，所示气管支气管影通畅，纵隔内未见明显肿大淋巴结，胸腔未见积液征
象。
CT诊断：1，右肺下叶小结节影。建议随访。2，右上肺陈旧性病灶。
现在去了上海的中山医院，胸外科的王群副主任医师给出的治疗方案是切除右肺下部1/
3。
诊断意见是，不管良性，恶性，切点比较好。
出发点是结节位置和边缘欠光整，60％可能性是恶性。
我爸爸67岁，身体一直很正常，不吸烟，肺部没有任何不适。
我比较担心的是手术的安全性，以及治疗方案的合理性。下周就要动手术了，
请教各位专家，非常感谢！ | f******I
发帖数: 769 | 2
1/
you didn't say how big the nodule is, and if it's calcified,
most of benign nodules are calcified, less than 2cm, and with smooth margin,
but then again these criteria is not foolproof,
【在 s********e 的大作中提到】
: 我爸爸X光检查出有阴影，
: CT检查如下：
: CT所见：右上肺见索条状密度影。右肺下叶背段见一小结节影，边缘欠光整。两肺门
: 区未见异常，所示气管支气管影通畅，纵隔内未见明显肿大淋巴结，胸腔未见积液征
: 象。
: CT诊断：1，右肺下叶小结节影。建议随访。2，右上肺陈旧性病灶。
: 现在去了上海的中山医院，胸外科的王群副主任医师给出的治疗方案是切除右肺下部1/
: 3。
: 诊断意见是，不管良性，恶性，切点比较好。
: 出发点是结节位置和边缘欠光整，60％可能性是恶性。
| s********e
发帖数: 136 | 3 Thanks a lot for the information.
The nodule is a sphere with radius around 1cm.
The problem is that CT result ‘边缘欠光整'
Thanks again for your opionion.
margin,
【在 f******I 的大作中提到】
:
: 1/
: you didn't say how big the nodule is, and if it's calcified,
: most of benign nodules are calcified, less than 2cm, and with smooth margin,
: but then again these criteria is not foolproof,
| f******I
发帖数: 769 | 4
idealy you'd like to know if there was a lesion there before, like an old
film to compare with,
a couple options you have,
1. wait another 3-6 months and get another film to see if it's the same size,
2. get a PET scan to see if there is increased metabolic activities often
seen in cancer,or
3, just cut it out,
one of my good friends told me he was doing rotation with a surgeon placing
a chest tube for someone with pneumothorax and the surgeon felt there was
something grainy under his glove in
【在 s********e 的大作中提到】
: Thanks a lot for the information.
: The nodule is a sphere with radius around 1cm.
: The problem is that CT result ‘边缘欠光整'
: Thanks again for your opionion.
:
: margin,
| s********e
发帖数: 136 | 5 非常感谢你的comments.
再想请教一下这个手术的危险性高不高？（切除右下肺1/3)
我爸爸以前的肺部扫描都很正常。现在右下肺正中有小结点，（边缘欠光整）右上肺见
索条状密度影。我担心切掉右下肺，那右上肺的阴影会是什么性质？
再次感谢你的帮助。
size,
placing
【在 f******I 的大作中提到】
:
: idealy you'd like to know if there was a lesion there before, like an old
: film to compare with,
: a couple options you have,
: 1. wait another 3-6 months and get another film to see if it's the same size,
: 2. get a PET scan to see if there is increased metabolic activities often
: seen in cancer,or
: 3, just cut it out,
: one of my good friends told me he was doing rotation with a surgeon placing
: a chest tube for someone with pneumothorax and the surgeon felt there was
| f******I
发帖数: 769 | 6 you need to have pulmonary function test to see how much lobectomy will
affect his lung function after the surgery, i don't know what it meant for
the right upper lobe, though, | t****a
发帖数: 1707 | 7 ....医院这样说的吗?
我是外行,我记得有次找熟人的时候，听到会诊出来的医生们在谈一个病人的手术,
虽然是恶性,但他们决定不动手术，采取保守治疗,原因很简单，是快70岁的老人，他们
觉得意义不大,光是手术本身就足够消耗大量元气.
我是外行,说说而已. | t****a
发帖数: 1707 | 8 还有一个问题,既然是肺结核,就应该去肺结核防治治疗中心(研究所)
任何大医院都不具备对肺结核的专业治疗,只有肺结核中心才最有发言权 | f******I
发帖数: 769 | 9
i think the CT result showed pulmonary nodule, not tuberculosis(by the way,
you don't diagnose TB with CT scan),
【在 t****a 的大作中提到】
: 还有一个问题,既然是肺结核,就应该去肺结核防治治疗中心(研究所)
: 任何大医院都不具备对肺结核的专业治疗,只有肺结核中心才最有发言权
| f******I
发帖数: 769 | 10
it's quite reasonable that sometimes conservative measures are taken instead
of aggressive treatment, but it should be tailored to the individual,
including his or her medical condition, overall prognosis, and patient's
personal wish,lots of times, doing less is doing more,
【在 t****a 的大作中提到】
: ....医院这样说的吗?
: 我是外行,我记得有次找熟人的时候，听到会诊出来的医生们在谈一个病人的手术,
: 虽然是恶性,但他们决定不动手术，采取保守治疗,原因很简单，是快70岁的老人，他们
: 觉得意义不大,光是手术本身就足够消耗大量元气.
: 我是外行,说说而已.
| s********e
发帖数: 136 | 11 爸爸做完手术了，手术比较成功，诊断为细支气管肺泡癌，
【门诊诊断】 右下肺MT
【入院诊断】 右下肺MT
【出院诊断】 右下肺MT （T1N0M0 IA）
【病理诊断】 (S2008-35731):(右下肺)细支气管肺泡细胞癌,粘液型,支气管切缘未
见癌累及,酶标(08-N3707):MUC-1(-),MUC-2(-),MUC-5(+),MUC-6(+),CD34 (-),CK7(++)
;,另送检2-4组淋巴结3枚,7组淋巴结2枚,9组淋巴结1枚,11组淋巴结3枚,均未见癌转移.
请教各位专家，这个病例糟糕度如何？什么是MT? 手术后应该注意什么？
万分感激！
1/ | f******I
发帖数: 769 | 12
+)
移.
glad to hear that, sounds like adenocarcinoma, which is the most commonly
seen non-small cell lung cancer, my ex-girlfriend's dad died from this,
from what you said staging is IA, T1N0M0, if it's T1, meaning the size is
less than 3cm, N0 means no lymph node involvement, and M0 means no distant
metstases,
overall the stage by stage comparison adenocarcinoma of the lung has the
worse prognosis comparing to other non-small cell lung cancer, except 1A,
the survival rate for stage 1A in 5 year
【在 s********e 的大作中提到】
: 爸爸做完手术了，手术比较成功，诊断为细支气管肺泡癌，
: 【门诊诊断】 右下肺MT
: 【入院诊断】 右下肺MT
: 【出院诊断】 右下肺MT （T1N0M0 IA）
: 【病理诊断】 (S2008-35731):(右下肺)细支气管肺泡细胞癌,粘液型,支气管切缘未
: 见癌累及,酶标(08-N3707):MUC-1(-),MUC-2(-),MUC-5(+),MUC-6(+),CD34 (-),CK7(++)
: ;,另送检2-4组淋巴结3枚,7组淋巴结2枚,9组淋巴结1枚,11组淋巴结3枚,均未见癌转移.
: 请教各位专家，这个病例糟糕度如何？什么是MT? 手术后应该注意什么？
: 万分感激！
: 1/
| s********e
发帖数: 136 | 13 Thanks a lot for your input,
I really apprieate that.
We didn't tell my father the truth. But told him 良性肿瘤。
We want to keep him opmistic, which might be helpful for his recovery.
thanks again,
of
【在 f******I 的大作中提到】
:
: +)
: 移.
: glad to hear that, sounds like adenocarcinoma, which is the most commonly
: seen non-small cell lung cancer, my ex-girlfriend's dad died from this,
: from what you said staging is IA, T1N0M0, if it's T1, meaning the size is
: less than 3cm, N0 means no lymph node involvement, and M0 means no distant
: metstases,
: overall the stage by stage comparison adenocarcinoma of the lung has the
: worse prognosis comparing to other non-small cell lung cancer, except 1A,
|
|
