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肉眼检查: |
长春晚报:“谁来为我所失去的四个健康器官埋单?” | |
作者:不详 | |
病理报告出来后,她从医生的表情里看到了惋惜 李娟今年27岁,是长春市某电视台的节目主持人。2004年12月26日,因身体不适,李娟到长春市某医院作检查,结果发现左侧卵巢有一实质性不均质包块(肿瘤)。这个结果不免让李娟有些担心,为了不耽误工作,李娟赶回台里请了3天病假,并录制完成了以后半个月的节目。也正是这一天,李娟接到了节目组颁发的“十佳员工”证书。 2004年12月29日11时,在朋友王某的陪同下,李娟来到该院做肿瘤切除手术。手术前,李娟叮嘱王某,如果病理检测结果是恶性肿瘤,要赶紧通知她的家人,若是良性肿瘤就不要惊动他们了。 医生对李娟实施了局部麻醉,整个手术过程中李娟都很清醒。 快速病理结果出来后,李娟听到医护人员低声私语,医生对病理结果表示质疑,并提出再次检测。第二次的检测结果出来后,医生沉默了,从医生的表情里,李娟看到了一种惋惜。 李娟小声问护士:“是癌症吗?你告诉我吧!”护士点了点头,李娟的大脑瞬间一片空白,这个结果无异于对她宣判了“死刑”。 “你的病理检查报告结论为:(左侧卵巢)黏液性腺癌。手术方案有两种,你可以选择将双侧卵巢全部切除,或只切除一侧卵巢!”医生的话把躺在手术台上的李娟“拽”了回来。 李娟患癌症的消息不胫而走,台里的领导和同事经常去探望她、鼓励她,台里还为她解决了一部分医疗费用。以前李娟做节目时帮助过的人也来到病床边,一位盲人由于家境窘迫,扛来了一袋大米,表达自己的关心。 第一天化疗结束了,李娟什么东西都吃不下,王某把熬好的鸡汤端给她,她却连看都不看一眼。从这一天起,李娟很少再和王某说话,但王某却一直不离不弃始终伴她左右。 为了庆祝自己“劫后余生”,李娟和王某来到北京前门的一家烤鸭店,可王某比李娟还激动,一口东西没吃,一直坐在那里哭。回到家后,李娟紧紧地抱着父母,一家人哭成了一团。 | |
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I basically share the view with Dr. Joe Ma's comments. However, I think we as pathologists should learn something from this report, even though it may be exaggerated in the news report. One lesson we should learn from this case is the " proper or right phrase" of our frozen diagnosis. As the rule of thumb, when you encounter a mucinous tumor of the ovary, you should know the correct diagnosis relying on the thorough sampling following the rule of at least one section per centimeter of the tumor mass. Therefore, one frozen section of a 10 CM tumor is impossible to provide accurate diagnosis unless it is frankly malignant. Therefore, in many hospitals in US, we often use the term " At least mucinous borderline tumor, defer to permanent section evaluation for final diagnosis" for frozen section diagnosis. You need pick up phone and communicate with surgeon about the reason and concern of your diagnosis. I have been a student of many world-renown pathologists. One thing I learn from all of them is that we pathologists should know our own limitation. In this case, if a diagnosis of "At least mucinous boderlne tumor" was given, it will dictate surgeon for properly staging the patient, leave space for him or her to provide accurate diagnosis at permanent, without concerning of "amending previous over diagnosis, and will prevent patient suffering further chemotherapeautic treatment. We are getting smarter because we made mistakes. Hopefully we all learn sth from this report and keep improving ourselves in our pathology career. 共勉