Chapter 334 Final diagnosis! Tricky abnormal lesions!

Five or six years ago, Wang Fan was just a medical student interning at Linhai First Hospital.

He was not talkative at that time. When Wang Ping, the instructor, asked questions and asked about cases, other interns would open their mouths and say a few words, but Wang Fan was in a daze with dark circles under his eyes.

Until one time, a patient suspected of arthritis came to the emergency department.

The characteristics are pain in multiple parts of the body, accompanied by increased pain sensitivity, etc.

The emergency department suspected that it was rheumatoid arthritis or chronic fatigue syndrome, and wanted to transfer to the rheumatology and immunology department.

As a result, Wang Fan suddenly spoke and said that the patient looked a bit like "fibromyalgia".

Wang Ping was stunned for a moment, and after careful recollection, he suddenly found that fibromyalgia was much more reliable than rheumatoid arthritis and other diagnoses.

He took other interns to make rounds for the patient again, and at the same time called a doctor from the rheumatology department to come for consultation, and finally the diagnosis was consistent.

Wang Ping was very surprised and praised Wang Fan when he returned to the department.

After a few words, Wang Ping saw Vio syndrome on the computer.

The scientific name is Wiskott-Aldrich syndrome. This disease is a multidisciplinary syndrome that spans genetics, immunity, blood, and tumors. It is also at the forefront of academia. It has not even been named in China, so Wang Ping transliterated it into Wiskott syndrome.

He casually asked who knew Wiskott syndrome.

As expected, the interns were all confused.

Wang Ping was about to take the opportunity to reprimand the students for not taking the initiative to learn about cutting-edge academics, but Wang Fan in the corner silently raised his hand.

Then, Wang Fan not only said the full name of Wiskott syndrome, "Wiskott-Aldrich syndrome", but also mentioned that it has three major characteristics: chronic eczema, platelet and combined immune abnormalities, and is a sex-linked recessive genetic disease...

Wang Ping was shocked.

Wang Fan seemed to think that it was not enough, and pointed to a book of more than 700 pages next to Wang Ping's desk and said, "On page 327, the second line under the title."

Wang Ping flipped it open in horror and found that page 327 really recorded this rare disease.

Since then, Wang Ping would skip Wang Fan when answering all the questions during the ward rounds. After all, the questions were too simple for him, so he had to leave some opportunities for other interns.

It was not until the end of the internship that Wang Ping made an exception and kept Wang Fan, a genius.

In the following months, Wang Ping learned that the reason why Wang Fan could blurt out "fibromyalgia" was because he was busy preparing for the postgraduate entrance examination and happened to review this disease the night before.

And Viot syndrome...

That was because when he and other interns went to consult with the rheumatologist, he was bored in the department and happened to see Viot syndrome on Wang Ping's computer. He felt that the explanation was a bit vague, so he opened the book next to him and read it for a long time, but he didn't understand anything. After finishing the work, he only remembered the page number of the catalog.

He lowered his head and said nothing when asking questions because he really didn't know how to do it. It was not disdain...

But later Wang Ping found that the goods were not what he wanted, and it was too late to regret it.

Wang Fan inexplicably did what the top five majors that year couldn't accomplish, and he was kept in the hospital as an exception.

Until now, Xiao Wang still thinks that he was able to stay because of his diligence.

But the truth is... he pretended to be the right two big shots at the right time.

...

"He Hai specially hired someone and quickly promoted him to director, and Linhai First Hospital was thriving.

I made an exception to keep a guy in the hospital, but I didn't have the face to ask for a quota in the following years..."

Wang Ping sighed.

Recalling the past, he suddenly felt that the guilt in his heart for commanding Wang Fan to dig out feces was not so serious.

"Hurry up and catch up."

Wang Ping put his hands behind his back, sighed twice, and planned to go to the ward.

Just then, he realized that something was wrong, glanced back, and his pupils shrank.

There was only Wang Fan behind him, and a few interns.

"???"

Wang Ping didn't react a little, and asked: "Where are the others? The director is making rounds, and he won't come to participate?"

Wang Fan grinned and said: "Director Wang, the others followed Brother Xu to see the key patients."

"Run away?!"

Wang Ping was dumbfounded.

The director's ward rounds were obviously a grand event for the department, and no one wanted to miss it.

Damn, why did everyone go to Xu Qiu's side?

"Director, let's go, ward rounds?" Wang Fan said expectantly.

On Xu Qiu's side, the interns had all crowded into the corridor. They ran slowly and could not see anything, so they could only run back to hang out with Director Wang.

"Wang Fan, in the end, you are the most sensible."

Wang Ping patted Xiao Wang's shoulder with relief, thinking that he was indeed the person he recruited. Between Xu Qiu and himself, he still firmly chose the latter.

"It should be, it should be." Wang Fan scratched his head and smiled very innocently.

...

At noon, after both sides finished the ward rounds, Xu Qiu finally waited for the examination report from the imaging department.

This lesion was particularly tricky.

Zhang Hao did not find it at the first time.

However, he followed Xu Qiu's instructions, carefully searched in the pineal area, compared it many times, and worked overtime for more than two hours, and he really saw some abnormal signals in the pineal area.

After multiple sequences were confirmed, a short T1 and T2 signal was successfully marked, with a certain degree of enhancement, and an abnormal area of ​​necrosis was visible.

Although it cannot be directly confirmed as a pineal brain tumor.

But...

The appearance of an abnormal signal in this area is already quite suspicious.

"Sure enough, it's here."

Xu Qiu was not surprised.

Combined with Tao Changhan's precocious puberty and neurological symptoms, it has been basically confirmed that it is a pineal brain tumor.

After confirming the diagnosis, Xu Qiu's mood also became heavier.

Pineal region...

The tumor in this area is very deep, and there are many important structures passing through it, and the return veins are also concentrated, so the operation is very difficult.

Therefore, many neurosurgeons are reluctant to touch this type of operation.

Even if it is the Medical Oncology Hospital or Zhongshan Cancer Hospital, they will not do it if they can.

After all, its risk is no different from intracranial bomb disposal.

Dinglingling——

Before Xu Qiu finished reading the examination report, Zhang Hao called him immediately.

"Doctor Xu, what are you going to do next? Continue the examination?"

According to the general process, if a suspected tumor lesion is found, the next step is to do a puncture for further diagnosis.

But for tumors in the pineal region, a biopsy is obviously unrealistic and too dangerous.

Therefore, most people can only choose simple radiotherapy.

As for radiotherapy and chemotherapy, they basically use a wide-margin local field irradiation of 25 Gy/3 weeks, and then perform a CT scan to compare with the CT film before treatment to determine the changes in the size and nature of the tumor.

If the tumor is significantly reduced, the result is very pessimistic, indicating that the tumor is a very malignant tumor such as a germ cell tumor.

At this time, a minimally invasive awake craniotomy must be performed.

However, for Tao Changhan, this method is obviously not feasible, and he has a huge problem!

——

The third update is coming!