Chapter 803: Lung adenocarcinoma with many suspicious points
On Jiang Donger’s pathology report, there was a line of diagnostic opinion:
"A few abnormal cells were consistent with adenocarcinoma."
…
"(Upper right) A few mutated cells are consistent with adenocarcinoma, with no obvious invasion of blood vessels and nerves, accompanied by metastasis of the tenth group of lymph nodes (2/6).
"Immunohistochemistry TIF-1(+)NapsinA(+)CK7(+)..."
In the ward, Father Jiang flicked the pathology report on his phone with trembling fingers.
Mother Jiang was chatting with her daughter.
She also knew that the pathology results would probably be released today, but she didn't dare to ask for fear of any bad results.
And she is a person who cannot hide her emotions...
"What's for lunch?" At this time, Dad Jiang put away his phone and walked over, asking as usual.
He digested the bad news calmly... He was worried that neither mother nor daughter could bear this reality.
But Jiang Donger was not fooled so easily. She turned on her phone and muttered: "The pathological examination should be out. Let me take a look at my report..."
Father Jiang's pupils shrank and he subconsciously tried to stop him.
Jiang Donger looked at the palm pressing on her mobile phone. She was stunned for a moment, and the smile on her face disappeared for a moment. When she raised her head again, she had a smile on her face again and said: "Dad, I have guessed Here it is... You don’t have to hide this kind of thing from me. If I have lung cancer, I want to know clearly how long I have left, so that I can live my life more planned. "
After saying this, Jiang Donger was stunned for a moment.
She didn't expect that she could say such philosophical words... Obviously she was a clueless person who only knew how to laugh and laugh.
"Sure enough, I have literary bacteria... No, literary cells!" Jiang Dong'er said with a chuckle.
Mother Jiang said angrily: "Be more serious."
The family of three couldn't help laughing.
Dad Jiang wiped his eyes, hesitated, and finally let go of the hand holding the phone.
Looking at his daughter again, he suddenly realized that the child under the protection of himself and his wife had grown up long ago, and she was already capable of making any decision.
"A few abnormal cells are consistent with adenocarcinoma (lung adenocarcinoma)..."
Mother Jiang looked at the pathological diagnosis on her phone and covered her mouth in panic.
Jiang Dong'er read it calmly. She glanced at her mother with feigned disgust and said, "You usually quarrel with me, but you are so weak!"
Mother Jiang raised her hand to hit her, but it turned into a gentle caress. She gently hugged her daughter.
By the time Xu Qiu came over for ward rounds, the family had already adjusted their mood.
But looking at the reddish eyes of the three people, it can be inferred that this family must have cried.
"Doctor Xu, can my daughter be saved?" Father Jiang asked directly.
Xu Qiu said calmly: "It depends on the situation."
The pathological types of lung cancer can be roughly divided into small cell carcinoma and non-small cell carcinoma. Lung adenocarcinoma is one of the latter. In principle, it cannot be cured, but it is not the most serious type.
Judging from Jiang Donger's situation, if the mass in the upper lobe of the right lung is the main focus of adenocarcinoma, there is a high probability that it has metastasized to the pleura and other places, and the chance of surgery will be completely lost...
So now there are two main tasks.
The first is to further confirm the type and origin of adenocarcinoma.
The second is to determine the type of genetic mutation in adenocarcinoma.
"If the financial situation is good, we can continue to do a PET-CT and draw peripheral blood for genetic testing." Xu Qiu explained the reason and gave the plan.
Just like targeted drugs for liver cancer, after lung cancer is diagnosed, gene mutation testing should be done immediately to confirm whether the cancer has mutated. If it is common EGFR and ALK mutations, there are clinically targeted drugs. .
But if there is no genetic mutation, or if there are mutations that cannot be covered by targeted drugs, we can only accept the worst outcome.
"But now there is another problem..." Xu Qiu paused and then said.
He looked at Jiang Dong'er and asked, "Does your body still hurt today?"
"There are still some..." Jiang Dong'er lowered his head.
Xu Qiu nodded.
The cause of chest pain should be lung adenocarcinoma, but what about body pain?
In the past few days, Xu Qiu tried many methods to find the source of the pain.
Such as diagnostic block therapy...
However, the effect is not good, and lumbosacral plexus nerve root inflammation and related lesions can be ruled out.
In addition, the pelvic CT scans done these days also found no abnormalities.
Xu Qiu was at a loss for ideas at first, but when he saw the pathology of lung adenocarcinoma, he suddenly came up with a guess...
Could it be lung cancer that has metastasized from bone cancer?
As soon as this idea appeared, I couldn’t contain it anymore…
The phenomenon of pain caused by bone cancer is too common, and this kind of pain cannot be relieved by block therapy, which is completely consistent with Jiang Donger's performance.
But...if it is bone cancer, it may bring a greater blow to the family.
Simple lung adenocarcinoma is already very difficult to treat. If it is bone cancer + lung metastasis, there is a high probability that you will have to wait for death.
"In addition, I suggest doing another bone scan..." Although cruel, Xu Qiu still gave professional advice.
"Bone scan? My daughter..." Father Jiang's face became even uglier. His face was sullen and his emotions could not be seen, but everyone could feel his suppressed pain.
Xu Qiu hesitated for a moment, judging whether the other party could accept it.
But Father Jiang said directly: "Dr. Xu, just say it. Our family has prepared for the worst, and we accept the outcome no matter what."
Xu Qiu then explained: "The patient's chest pain should come from lung adenocarcinoma, but the pain all over the body cannot be explained. Judging from the current situation, this symptom may come from osteoma. Similarly, lung adenocarcinoma It may also come from bone metastasis..."
Transfer... When Father Jiang heard these two words, he felt like he had been struck by a bolt from the blue.
Anyone with medical knowledge knows that tumor metastasis is equivalent to losing the chance of treatment!
"Dr. Xu, hasn't my daughter had a pelvic CT scan? No bone cancer was found..." Father Jiang said with a glimmer of hope.
Xu Qiu said patiently: "Bone scan can show all lesions, which is more accurate than pelvic CT. Some small lesions that cannot be shown by CT, or the density of bone cancer that is covered up, will show radionuclide concentration in the bone scan, showing Got it all clear.”
Hearing this, Dad Jiang completely accepted the reality. After a long silence, he asked: "If it is bone cancer, is there any hope?"
Xu Qiu thought for a while and said: "It's not completely untreatable. Besides, it hasn't been diagnosed yet."
Jiang Donger's originally gloomy eyes showed a glimmer of light...meaning there is still a chance for treatment?
"Doctor Xu, please help me get a check list quickly. I'll do it now!" Jiang Dong'er said eagerly.
Father Jiang also reacted quickly and said quickly: "Yes, we can't delay any longer. Let's go check it out now and get a clear diagnosis of this disease!"
