w***b
发帖数: 86 | 1 老爷子今年三月份因咳嗽就医：
CT检查： 有块
PPD： 强阳性（有鸡蛋那么大）
被诊断为肺结核
吃了两个月抗结核药，CT检查，快没变小。
五月PET检查，支气管镜检，被诊断为肺癌。（大医院的肺科门诊，看的肺癌专家号）
现手术切除肿块和周边淋巴，病理结果：肺腺癌，没扩散到淋巴。
我的问题是，
如果肺癌并发肺结核，手术切除的肿块，医院会同时检测腺癌细胞和结核菌细胞吗？
现在病理结果只说有肺腺癌，是否可以确诊没有结核病。病人家属是否要继续做防肺结
核的措施？ |
g*****j
发帖数: 1211 | 2 You should still finish the TB therapy.
TB is a systemic disease, and cannot be treated with local excision. In
other words, once you are diagnosed with TB, the bacteria can be any where
in your body, and you should finish the regimen to assure complete
eradication. |
w***b
发帖数: 86 | 3 非常感谢你的回答。
如果之前的肺结核诊断是对的，我知道还要同时进行肺结核的治疗。
我的疑问是，
1.肺癌手术后的病理检测，是否只检测肿瘤的恶良性及种类，根本不管有没有结核菌？
2.如果这样，之前的”肺结核“结论还是不确定，虽然PPD强阳性，但这不是金标准。对
吗？
In
where
【在 g*****j 的大作中提到】
: You should still finish the TB therapy.
: TB is a systemic disease, and cannot be treated with local excision. In
: other words, once you are diagnosed with TB, the bacteria can be any where
: in your body, and you should finish the regimen to assure complete
: eradication.
|
g*****j
发帖数: 1211 | 4 TB identification requires special procedure in pathology exam. I guess
most likely the surgeon did not order TB testing in the first place.
Now let's assume it were ordered. The negative result on pathology does not
rule out TB anyway, because your father has been on antibiotics for a while
and the bacterial load has been decreased. Your father need to finish the
regimen regardless of the TB pathology result. His doctor did not right
thing not to order the test that won't change the manage |
w***b
发帖数: 86 | 5 非常感谢你。我明白了。
not
while
the
【在 g*****j 的大作中提到】
: TB identification requires special procedure in pathology exam. I guess
: most likely the surgeon did not order TB testing in the first place.
: Now let's assume it were ordered. The negative result on pathology does not
: rule out TB anyway, because your father has been on antibiotics for a while
: and the bacterial load has been decreased. Your father need to finish the
: regimen regardless of the TB pathology result. His doctor did not right
: thing not to order the test that won't change the manage
|
c********e
发帖数: 496 | 6 I got the message, but what's the question? |
w***b
发帖数: 86 | 7 我的问题在{1}{3}楼。
手术当天就被告知是肺腺癌。淋巴的病理结果是四天后告知的。
我就是想知道，之前被诊断的“肺结核”到底怎样才能确诊。刀都开了，东西都拿出来了，怎么还是不置
可否。（楼上gordonj 说得很有逻辑，好像结果就是不置可否啊，唉）
肺癌专家说之前的诊断不对，现在只按肺癌治。
如果确实有肺结核，现在抗痨药都停了，无疑是雪上加霜。
如果没有肺结核，又坚持用抗痨药，对一个癌症病人，也是要命的事啊
【在 c********e 的大作中提到】
: I got the message, but what's the question?
|
