g*****n
发帖数: 21 | 1 手指中间的一段，一按就有些痛，有很久时间了（2年左右），最近跟医生说起，让我
去照x光，有阴影，又让照了MRI。 现在还不清楚，又说让照mri with contrast。我两
年办前得了甲亢，不知道是不是报告里的brown tumor。
这是MRI的检验报告：
1. Nonspecific lesion involving the medullary portion of of the middle
phalanx
left hand fourth digit without significant expansion of the bone but with
mild
cortical thinning and slightly ill-defined margins. Associated edema of the
adjacent surrounding soft tissues. Finding is considered nonspecific but
definitive cyst or fluid fluid levels are not identified. The surrounding
soft
tissue edema is somewhat worrisome as well as the somewhat ill-defined
margins
particularly distally. Differential would include benign entities such as
reparative granulomatous change or possibly more rare giant cell tumor,
possible brown tumor related to thyroid or parathyroid disease or infection
however given the surrounding edema more aggressive process such as
eosinophilic granuloma Ewing's sarcoma small cell tumor cannot be excluded
the
lesion does not appear to demonstrate findings suggestive of a cystic nature
excluding solitary bone cyst or aneurysmal bone cyst. Lack of significant
expansion argues against fibrous dysplasia and less likely felt to represent
enchondroma although not absolutely excluded. Contrast-enhanced study may
be
useful to assess intact there is diffuse solid enhancement consistent with a
solid lesion as opposed to cystic component and also to assess for
enhancement
the the cortical bone into the adjacent soft tissues. Diagnosis will likely
require biopsy.
究竟要MRI with contrast还是biopsy啊？听说两个都又副作用啊。究竟哪个测试能确
诊呢？我该怎么办？只是手指有点痛啊。现在整个人都懵了。。。。。
请各位高手给点建议啊。 谢谢！ |
R****y
发帖数: 411 | 2 Start with MRI with contrast, biopsy is a lot more invasive than getting IV
contrast ( assuming your renal function is ok). I don't see a lot of key
words indication malignant features other than indistinct margin and edema
which are nonspecific descriptors. |
g*****n
发帖数: 21 | 3 今天去看了骨科医生，他说绝大部分情况是内生软骨瘤，但是要确诊的话就要做手术植
骨。因为现在我无疼痛感，也没其他异样，可以先观察三个月，再看看这个瘤有无增长
。他这个说法靠谱吗？
谢谢！
IV
【在 R****y 的大作中提到】
: Start with MRI with contrast, biopsy is a lot more invasive than getting IV
: contrast ( assuming your renal function is ok). I don't see a lot of key
: words indication malignant features other than indistinct margin and edema
: which are nonspecific descriptors.
|
R****y
发帖数: 411 | 4 Enchodroma? Don't sure about the procedure you mentioned. Regardless, I
prefer conservative management in absence of malignant features, but don't
hesitate if your clinical situation changes. Good luck |
j****i
发帖数: 496 | 5 My sister-in-law died from soft tissue sarcoma at 36, and my cousin's son
died from Ewing's sarcoma at 5. I'm not trying to scare you. Young people
get cancers, and when they do, tumor tends to be more aggressive types.
None of my doctors thought I had cancer at 35, but I persisted and they were
all stunned at the path findings. As long as cancer is in the differential
, I would not hesitate to get a biopsy done ASAP. |
l*h
发帖数: 4124 | 6 i don't think surveillance MRI has the ability to solve the question of
diagnosis.
【在 g*****n 的大作中提到】
: 今天去看了骨科医生，他说绝大部分情况是内生软骨瘤，但是要确诊的话就要做手术植
: 骨。因为现在我无疼痛感，也没其他异样，可以先观察三个月，再看看这个瘤有无增长
: 。他这个说法靠谱吗？
: 谢谢！
:
: IV
|
