本帖最后由 一切安好 于 2013-11-10 11:59 编辑
今年8月份,无意中发现脖子正前方有一个小小的突起,不明显,于是去看了我的家庭医生,当时医生说好像看不太出来,说让我照个B超看看
8月12号第一次B超,一周后结果出来,说可能是甲状腺舌管囊肿,大小0.9*1*0.4,家庭医生帮我安排了头颈专科医生,这里看专科难,约到时间是2个月以后,但是还没等我看到专科的时候,有一天我又发现锁骨上方,也有一个肿块,应该是淋巴结肿大,于是第二次去看家庭医生,又开了第二次B超
9月27号做了第二次B超,以前的正前方肿块长大了一些1.4*1.2*1.1,左侧发现多个淋巴结,是大的2.6*1.9*1.7,这时已经快到看上专科医生的时间
10月20号左右看了专科,头颈医生告诉我不是癌,于是放心了许多,但是如果是甲状腺可能要做手术,所以又给我安排了CT
10月21号做了CT,第二天就通知我结果出来了,心里感觉很不妙,因为在加拿大做检查没事的,一般出来的很慢,有事的就会加急出来,结果显示,肿块大小5.4*6.2*9.3,最大的淋巴结是1.6,这时专科医生也感觉到很吃惊,于是又安排做细针穿刺,
CT结果:10月21号做CT检查, There isa 5.4x6.2x9.3cm soft tissue mass located essentially below the left lobe of thethyroid gland although it aslo extends lateral and posterior to the left lobeof the thyroid gland and extends inferiorly into the chest down to the level ofthe aortic arch with deviation and compression of the thyroid gland as well asthe trachea which is compressed and deviated to the right .The mass itselfshows some internal blood vessels as well as a nodule of enhancing tissue orhyper-dense tissue measuring roughly 0.7cm in diameter which could be relatedto a focal area of tumour enhancement or possibly due to a nodule of thyroidtissue separated from the main portionof the thyroid gland by the tumour .The soft tissue mass extends between thetrachea and the brachiocephalic artery and there is pretracheal adenopathy withlymph nodes measuring up to 1.6cm in short axis transverse diameter.Prevascular soft tissue is seen in the anterior mediastinum which likely is dueto residual thymic tissue which cannot be separated from the patient's neckmass. A prominent lymph node is noted anterior and superior to the rightsternoclavicular joint measuring approximately 0.8 cm in short axis dimension.The anterior thymic tissue extends to the inferior edge of the scan anteriorto the main pulmonary artery and ascending aorta. The neck mass may be related tomalignant neoplasms includinglymphoma ,thyroid or thymic malignancy. teratoma is unlikely given lack ofcalcification or fat in the mass. benign tumours are also less likely given theadjacent adenopathy and infiltratingnature of the mass. The mass isamenable to percutaneous ultrasoundguided biopsy which may be performed at your request for histologicalanalysis. It is noted that the pulmonaryapices appear clear. The salivary glandsare unremarkable . No definite mucosalmass lesion is seen in the upper air way but direct visualization of the upperair digestive tract may be helpful toassess for possible squamous cell primary with adenopathy in the neck/upperchest.
10月30号,做了穿刺,接下来又是等一周
穿刺结果:
DIAGNSIS
LEFT NECK MASS FNA, SIX SLIDES RECIVED AND ONE LIQUID-BASED SLIDE PREPARED FROM NEEDL RINSE
MICROSCOPY:
ASPIRATE SHOWS LARGE ATYPICAL CELLS WITH VERY PROMINENT NUCLEOLI, SUSPICIOUS FOR MALIGNANT CELLS
DIAGNOSIS,LEFT NECK LYMPH NODE FNA:SUSPICIOUS FOR MALIGNANT CELLS
LEFT LYMPH NODE FNA:
MICROSCOPY:
ASPIRTE SHOWS LARGE ATYPICAL CELLS SUSPICIOUS FOR MALIGNANT CELLS
COMMENT :
SUGGEST CORE OR EXCISIONAL BIOPSY FOR FUTHER INVESTGATION
这个结果医生告诉我是99%是癌,但目前还不能确认是哪一种癌,他说更像霍淋,需要进一步取得更多的细胞来检测,于是安排粗针穿刺,本来已经安排了上周5去医院做,结果他们说没有我的血检报告,万一出现问题,不好办,于是让我下周做了血检,再过来做穿刺。
目前症状,一直咳嗽 3周以上了,咳的现在肋骨疼,麻烦大家帮我看看,谢谢了~
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