Typical pathological manifestations are the main basis for diagnosing Castleman's disease. Now the diagnostic basis is very clear, so the diagnosis is naturally made clear.
Castleman's disease was discovered by Dr. Castleman in 1956, so it was named after him. This disease is also called giant lymph node hyperplasia. It is between benign and malignant tumors. It is a rare disease with different clinical manifestations and pathology.
A characteristic reactive lymphoproliferative disease, the most prominent feature of which is the presence of huge lymph node masses in the abdominal and thoracic cavities.
The cause is currently unknown, but a large number of current studies indicate that the occurrence of Castleman's disease is related to infection with human herpes virus 8 and human immunodeficiency virus, immune system dysfunction, excessive secretion of interleukin 6 and other factors.
Its pathogenesis is still unclear, but it mainly manifests as invasion of lymphoid tissue. The main clinical and pathological change is the reactive proliferation of lymph nodes caused by chronic inflammatory cell stimulation, resulting in the enlargement of single or multiple lymph nodes throughout the patient's body.
According to the number of involved lymph nodes, it is divided into monocentric type and multicentric type. The monocentric type means that there is only one lymph node or lymph node enlargement in one region. The multicentric type, as the name implies, means that the disease involves more than one lymph node, and more than one region.
The single-center type mostly occurs in people in their thirties and forties, and is common in the head and neck. Systemic symptoms are less common. This type can be treated with surgery, and the prognosis is relatively good.
The multicentric type mostly occurs in the 50s and 60s, and manifests as multiple lymph node enlargement and involvement of multiple organs, accompanied by long-term fever, weight loss, night sweats, general fatigue and other symptoms of systemic hypermetabolism, cytopenias, and hyperimmunoglobulinemia.
Such as systemic symptoms, this type of disease is often complicated and the prognosis is very poor.
The diagnosis of this disease relies on pathological biopsy. For treatment, if it can be surgically removed, try to do it; if the disease cannot be completely removed by surgery, the first choice treatment method is chemotherapy.
Director Jiang personally came to the ward with the pathology report. When Fu Xiaotao heard the name of the disease he suffered from, he felt relieved. No matter whether the disease could be cured or not, at least now he knew what disease he had. It would be better to know clearly.
It's better to be confused.
At this time, Fu Xiaotao's parents also had hope in their hearts. They had been feeling uncomfortable and regretful because of their son's illness. Now they finally figured out what the illness was. If this continues, is there a chance of cure? At least now it can be cured.
I have a thought. I didn’t even understand the disease before, so how can I talk about it?
But things are always not as good as imagined. Castleman's disease that Fu Xiaotao suffers from is multicentric. Patients of this type are expected to have poor health. It is said that few people survive more than two years, so the news brought by Director Jiang is only
It can be a mixed bag of good and bad.
After the diagnosis is clear, the next step is treatment. The difficulty in internal medicine is not in treatment, but in diagnosis. In surgery, diagnosis is easy, but the difficulty is in surgery.
For surgeons, the general diagnosis is relatively easy to figure out, but for the same disease, the surgical results of different doctors vary greatly. Internists are different. Internists have to spend a lot of energy on diagnosis. Once the diagnosis is clear, the rest of the treatment
There are guides for the methods that you can refer to, and they are similar to everyone.
Even rare diseases have treatment guidelines for rare diseases, but general treatment guidelines are generally lagging behind, but for the sake of safety, most doctors are willing to follow the guidelines, regardless of whether there is any effect, because doing so will have no effect regardless of the result.
Wrong, once you use some new methods outside of the guidelines, you may get into trouble if you are not careful.
"Treat with cetuximab first to see the effect. If it doesn't work, then use chemotherapy." Director Jiang told Fu Xiaotao.
"Chemotherapy? Is this a tumor?" Fu Xiaotao's parents immediately became alert.
Director Jiang explained: "This is a disease between benign tumors and malignant tumors. Now we at least understand what the disease is and how to treat it. As for the treatment effect, no one dares to draw conclusions now."
"Try it!" Fu Xiaotao's mother is relatively calm. Compared with the previous confusion, she has made great progress now.
But Fu Xiaotao's father is not so optimistic. He feels that the current situation is even worse. Before, he didn't know what the disease was. At least he was worried, not despair, but now he knows what the disease is, and the hope of cure is very slim. Now
The mood is despair.
Fu Xiaotao is different from his parents. When he went for a check-up, he saw Luo Jin's pictorial in the corridor. Fu Xiaotao knew Luo Jin's inspirational story. The spiritual power of role models is infinite. Fu Xiaotao is definitely like Luo Jin. As long as there is a glimmer of hope
Just go for 200%.
"Just follow your method of treatment. Can I see Professor Yang again?" Fu Xiaotao asked.
Director Jiang said: "I will help you contact him. He is very busy and the time is temporarily uncertain."
---
Regarding Castleman's disease, Wen Ruzheng's confidence is justified, because the number of reported cases of this disease is only in the single digits. Although the number of reported cases is in the single digits, the number in the population is far from that, because most doctors do not recognize it.
This disease, that is, this kind of patient never knows what disease he has.
When the dedicated Dr. Wen studied pathology knowledge, he read a large amount of literature from morning to night every day, and became familiar with the pathological characteristics of some rare diseases, whether in words or pictures. He did not expect such a rare disease.
Wen Ruzheng also came across this once-in-a-lifetime opportunity, but everything was shattered by Yang Ping in less than a minute.
Wen Ruzheng estimated that the time it took Yang Ping to look at the pathological slides was really not more than a minute. Even if he guessed, it wouldn't be so fast.
The next morning, when the shift was over in the pathology department, Wen Ru was reporting this valuable classic pathology slide to everyone. He should have been extremely proud, but now he was listless, and the whole reporting process seemed dull and boring.
This chapter is not over yet, please click on the next page to continue reading! This is definitely not the usual image of Dr. Wen, because the usual Dr. Wen explains pathological slides, especially the highly valuable pathological slides, with brows and eloquence for three days and three nights.
Don't repeat words.
Today, Dr. Wen took such a rare pathological slide and used boring language for more than ten minutes to talk about it. What's going on?
Everyone speculated that Dr. Wen must have suffered some kind of blow, but what else could defeat a man who once dared to run naked?
Falling out of love must be lovelorn. Dr. Wen may have encountered an unprecedented failure in his pursuit of the female doctor in the oncology department. Falling out of love is a painful thing, especially in the short term. Colleagues all speculated this, because for those who spend all day in the hospital
Dr. Wen, who studied pathological slides from morning to night in the science department, could not think of anything that would make him so downcast.
After the early shift, Director Guan asked his colleagues about Wen Ruzheng's situation in a subtle way, and how the good-spirited young man had turned into a wooden person. Everyone agreed that the problem lay in personal relationships.
In order to relieve the knot in Dr. Wen's heart, Director Guan called Wen Ruzheng into his office, closed the door, and poured him a glass of water. Wen Ruzheng took the cup and put it on the table without saying a word.
"Xiao Wen, you are still young. Don't block the forest with a tree. It's pointless to lock yourself in a small space. Every young person nowadays has not been in love for a few times. I was also like this at that time. I was in love for a few times.
Only one can make it."
Director Guan used himself as the protagonist of the story and fabricated some so-called experiences to enlighten Dr. Wen. He mainly felt that this would make Dr. Wen more sympathetic and would produce immediate results.
"A man is a man who can take things he can afford. I was in a worse situation than you at that time. I chased a beautiful girl for several years, and finally she married someone else. Look, am I not living a good life now? Have I ever been depressed?"
Wen Ruzheng raised his head and looked at Director Guan: "Decades have passed since your incident. Of course you are fine now."
"No, it's the latest thing!" Director Guan blurted out.
Wen Ruzheng immediately steeled himself and stared at Director Guan. Director Guan felt frightened for a moment, but at least the boy's eyes were bright now: "Is everything okay? I figured it out."
"I have always thought clearly. I was not afraid of streaking last time. How could I be afraid this time? I just don't understand. Professor Yang doesn't usually go to the pathology department. How can he be so powerful? How can he see it?"
Wen Ru was taking a sip of water and said.
Director Guan was confused: "Aren't you lovelorn? Running naked? What streaking?"
"I lost my bet with Professor Yang yesterday. I still ran naked, but this time I had to be naked, really naked." Wen Ruzheng said his problem.
"Aren't you lovelorn?" Director Guan was particularly embarrassed.
"No! If nothing happens, I'll go work first." Wen Ruzheng stood up.
"Xiao Wen, the things I just said are all fabricated, and they are all just to enlighten you."
"I know!"
"Don't take it to heart, it's all fiction."
"I know!"
"Don't go out and talk nonsense about this!"
''I know!"
''It's really fiction!"
''I know!"
---
Yang Ping had encountered this disease for the first time in reality. However, when reading literature in the system space, Yang Ping had seen this disease and then seen experimental subjects suffering from this disease, so he also
Not too unfamiliar.
The system space gives Yang Ping a lot of time, and Yang Ping spends all of it on studying. If the system gives Yang Ping the greatest support, it must be sufficient time. In just one nap, he may have studied several times.
sky.
We must go all out for every case. Now that we encounter this kind of case, Yang Ping begins to think about treatment options. Fu Xiaotao's condition is very serious. All current chemotherapy options are not very effective, and the chemotherapy drugs themselves have serious side effects.
, some of which are carcinogenic.
In medicine, many treatment options are making slow progress, because medical breakthroughs are very difficult, and each medical specialty is extremely professional. It is very difficult for a person to master the knowledge of this specialty in his lifetime, let alone transcend it.
Specialties span disciplines. Precisely because doctors are always limited to a narrow specialty, it is difficult to innovate. If we can break out of this limitation, innovation will become relatively easy.
Yang Ping reviewed the treatment methods for this disease. The cocktail therapy created by an American expert uses a combination of seven chemotherapy drugs. It is said to be the most advanced method in the world. In fact, Americans have a good spirit of innovation and deserve our
They can learn many things and come up with bold ideas and put them into practice.
Regarding the pathogenesis of Castleman's disease, Yang Ping summarized numerous literatures. It is generally accepted that the messenger interleukin 6 of the immune system is the most critical link in the pathogenesis. When lymph nodes secrete excessive interleukin 6, the immune system is abnormal.
Hyperactive, thus causing a strong local or systemic inflammatory reaction, so from a pathological nature, this is an inflammatory reaction, so the use of glucocorticoids is effective, but glucocorticoids only inhibit the inflammatory reaction, treating the symptoms but not the root cause, that is, it
It can only treat sewage, but cannot treat the source of pollution.
After thinking for a while, Yang Ping didn't get anything new of value, so he decided to reorganize the information on this disease to see if he could find out anything new.
Song Zimo knew that Wen Ruzheng was stubborn and was afraid that he would really run around naked without wearing underwear, so he called Wen Ruzheng specifically: "We are just joking, don't take it seriously."
But Wen Ruzheng didn't think so. The more this happened, the more he felt that he was looking down on himself: "I, Wen Ruzheng, stand upright and do what I say. How could it be a joke? Don't worry, I will choose a time to fulfill my promise, and I will never do it."
discount."
This Wen Ruzheng is really stubborn. According to him, his streaking this time will definitely be fulfilled, and he will honor it to the letter. This time it is a real streaking, naked kind.
When Song Zimo told Yang Ping the news, Yang Ping could only lament: Oh --- Dr. Wen is a man, Yang Ping can only say this.
Because there were many surgeries today, it was already past eleven o'clock in the evening when Yang Ping got off work. Yang Ping happened to bump into Wen Ruzheng at the entrance of the hospital. Wen Ruzheng saw that Yang Ping did not speak, but only made a gesture to say hello.
He held a stopwatch in his hand and stared at the road in front of the hospital, as if he was doing some test. He looked very serious, and Yang Ping was not allowed to disturb him.
At around six o'clock the next morning, when Yang Ping went to work, he saw Wen Ru doing a test again, still holding a stopwatch in his hand and staring at the road. What does this guy mean? Why is he so nervous? Night and morning
What are you doing with a stopwatch in your hand? Yang Ping didn't care about it.
In the doctor's office, the doctors were working and chatting. Zhang Lin's news was always the most timely. He told everyone that Wen Ruzheng was testing the flow of people on the four roads around the hospital yesterday, so as to decide when to run naked, because
The bet stipulates that wearing underwear is not allowed, but the time is up to him, so he is using scientific and rigorous statistical methods to accurately measure the flow of people around the hospital.
It is said that one day of testing cannot explain the problem. He will test it every few days and test it many times in a row, and eventually he will get a stable and accurate data. After getting the best streaking time, he will start to announce the streaking time.
As expected of Dr. Wen, he is a doctor in his work.
