#1
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Õîëàíãèîêàðöèíîìà
Äîáðûé âå÷åð.
Ìàìå 72 ãîäà, ðîñò 160, âåñ òî÷íî íå ìîãó ñêàçàòü, îêîëî 95êã +-. Æàëîáû íà çóä íà÷àëèñü â êîíöå ëåòà, â îêòÿáðå ñäàëà àíàëèçû - áûë ïîâûøåí áèëèðóáèí (ýòèõ àíàëèçîâ íà ðóêàõ íåò, áûë îêîëî 80 îáùèé, ïî-ìîåìó). Îòñóòñòâèå àïïåòèòà, ïîõóäåëà, íèêàêîãî äèàãíîçà íå ïîñòàâèëè, äðóãèõ æàëîá íå áûëî. Ïðèáëèçèòåëüíî 10-20 íîÿáðÿ íà÷àëàñü æåëòóõà, ãîñïèòàëèçèðîâàëè â õèðóðãè÷åñêîå îòäåëåíèå, ïðîâåëè îáñëåäîâàíèå, ïî äàííûì êò ñ êîíòðàñòîì ïîñòàâèëè äèàãíîç. Íà äíÿõ ïëàíèðóþò ïîñòàâèòü äðåíàæ è âñêîðå âûïèñàòü, ñîâåòóþò äàëåå îáðàùàòüñÿ â îíêîäèñïàíñåð. Âîïðîñû: 1. Åñòü ëè âåðîÿòíîñòü, ÷òî äèàãíîç ïî ÊÒ îøèáî÷íûé? Íèêàêèõ ïàòîëîãèé, ïðè êîòîðûõ âûñîê ðèñê ðàçâèòèÿ òàêîé îïóõîëè, íå áûëî. 2. Êàêîå ëå÷åíèå íà íàñòîÿùèé ìîìåíò ñ÷èòàåòñÿ â òàêîé ñèòóàöèè ñàìûì ïåðñïåêòèâíûì? 3. Ïîæàëóéñòà, ïîäñêàæèòå îíêîöåíòðû, â êîòîðûå èìååò ñìûñë îáðàòèòüñÿ, ìîæåò áûòü, ãäå-òî ïðèìåíÿþò áîëåå ñîâðåìåííîå ëå÷åíèå èëè ñïåöèàëèçèðóþòñÿ èìåííî íà òàêîì. Òåððèòîðèàëüíî áëèæå èç êðóïíûõ ãîðîäîâ â Êàçàíè. Ìàìà æèâ¸ò â Éîøêàð-Îëå. Êîãäà îáðàòèòüñÿ, êàê îáðàòèòüñÿ... Âîîáùå, áóäó áëàãîäàðíà çà ëþáûå ñîâåòû. ß ñîâåðøåííî â ðàñòåðÿííîñòè. çàðàíåå ñïàñèáî. |
#2
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îíêî-äèàãíîç ïîäòâåðæäàåòñÿ òîëüêî ïîñëå ðåç-òîâ áèîïñèè, èíîãäà ïîñëå îïåðàöèè, íà ÊÒ ìîãóò áûòü ïðèçíàêè îïóõîëè; îæèðåíèå = ðèñê-ôàêòîð äàííîé îïóõîëè;
ïðîãíîç íåáëàãîïðèÿòíûé â öåëîì è ìîãóò íå âçÿòüñÿ çà ëå÷åíèå ñîâñåì - õèðóðãèÿ, åñëè âîçìîæíà, ìîæåò ïðîäëèòü æèçíü ñ 3 äî 30 ìåñ. íî ìíîãî óìèðàåò â ïîñëåîïåð. ïåðèîäå Among patients 66-74 years of age, surgery alone resulted in a median overall survival (OS) of 30 months, surgery combined with chemotherapy 26 months, radiotherapy 17 months, chemotherapy alone 10 months and no therapy 3 months;
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Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
#3
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Òî åñòü òåîðåòè÷åñêè ìîæåò áûòü òàê, ÷òî íà ÊÒ ìîãóò ïðèíÿòü çà îïóõîëü ÷òî-òî äðóãîå, èëè áèîïñèÿ íóæíà ÷òîáû òàê ñêàçàòü äå-þðå ïîäòâåðäèòü äèàãíîç?
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#4
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ìèìèêðèÿ âñåãäà áûâàåò, èíîãäà îïóõîëü íå îïåðàáåëüíàÿ èëè íåâîçìîæíî âçÿòü áèîïñèþ, òîãäà îêîí÷. ãèñòîë. äèàãíîç òîëüêî ïîñòìîpòåì, ñêîðîòå÷íîñòü ïðîöåññà ïðåäïîëàãàåò çëîêà÷åñòâ. ïðèðîäó áîëåçíè; êàê ïðèìåð - åå òàê è íàçûâàþò ïñåâäî-îïóõîëü
Biliary inflammatory pseudotumors (IPTs) represent an exceptional benign cause of obstructive jaundice. These lesions are often mistaken for cholangiocarcinomas and are treated with major resections, because their final diagnosis can be achieved only after formal pathological examination of the resected specimen.
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Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
#5
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ß òàê ïîíÿëà, â íåêîòîðûõ ñëó÷àÿõ áåç áèîïñèè ñîâåðøåííî íåâîçìîæíî ðàçëè÷èòü, ÷òî ýòî òàêîå? À áèîïñèÿ ñàìà ïî ñåáå ñèòóàöèþ íå ñïîñîáíà óõóäøèòü?
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#6
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íóæíî ãîâîðèòü ñ òåìè, êòî åå áóäåò ïðîâîäèòü
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Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
#7
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Öèòàòà:
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Ñ óâàæåíèåì |
#8
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Çäðàâñòâóéòå. Ñêàæèòå, ïîæàëóéñòà, ìîæíî ëè ïðè òàêîì ñîñòîÿíèè ïå÷åíè (îáùèé áèëèðóáèí 137, ïðÿìîé 118) ïèòàíèå òèïà íóòðè äðèíê? ×òîáû íå òåðÿòü ñèëû. Èëè íå áóäåò íîðìàëüíî óñâàèâàòüñÿ? Èëè âäðóã âðåäíî? Ñïàñèáî
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