匿名使用者
匿名使用者 發問時間: 健康疾病與處置癌症 · 10 年前

SARCOMA 診斷證明看不懂?

最近生了一場重病

所以需要各位醫學先進協助說明

(我是一名31歲的男性)

根據醫生說明

敝人得的是一種惡性腫瘤

需要作過大切除手術

簡單的說明過程

12月下旬

先做一個簡單的門診手術

做完後

醫生拿的第一次的診斷證明

說這是惡性腫瘤

需要作擴大切除手術

所以在1月下旬的時候則進行全身麻醉的擴大切除手術

然後一次拿到了兩個診斷證明

醫生是說

因為在手術室的時候

先切一塊下來

發現邊邊還有癌細胞

所以就再切

因為這樣所以拿到兩個診斷證明

所以總共三個

第一個:DX:SKIN, LEFT INGUINAL, EXCISION---- DERMATOFIBROSARCOMA PROTUBERANS GROSS D:THE SPECIMEN SUBMITTED CONSISTS FO A PIECE OF TISSUE MEASURING 1.7*1.1*1 CM.ALL ARE SUBMITTED. CCY MICRO D:SECTIONS SHOW SPINDLE TUMOR CELLS AND MILD NUCLEAR ATYPIA WITH INVOLVEMENT OF DERMIS AND SUBCUTIS. THE MARGIN IS INVOLVED.

第二個: DX:SKIN, LEFT INGUINAL, EXCISION---- DERMATOFIBROSARCOMA PROTUBERANS GROSS D:THE SPECIMEN SUBMITTED CONSISTS OF ONE PIECE OF SKIN AND UNDERLYING SOFT TISSUE MEASURING 7.5*2.7*1.1 CM. THERE IS A ILL-DEFINED AND FIRM TUMOR MEASURING 1.5*1.4*0.9 CM. THE CUT SURFACES ARE GRAYISH WHITE. THE DEEP MARGIN IS INVOLVED BY THE TUMOR. REPRESENTATIVE SECTIONS ARE TAKEN AND LABELED A TO E. SU MICRO D:SECTIONS SHOW SPINDLE TUMOR CELLS AND STORIFORM ARRANGEMENT, MILD NUCLEAR ATYPIA WITH INVOLVEMENT OF DERMIS AND SUBCUTIS. THE DEEP SOFT TISSUE MARGIN IS INVOLVED.

第三個: DX:SOF TISSUE AND LYMPH NODE, LEFT INGUINAL (LN LOWER), 2ND BIOPSY------ NEGATIVE FOR MALIGNANCY GROSS D:THE SPECIMEN CONSISTS OF 2 TISSUE FRAGMENTS MEASURING 6.5*4.5*0.5 CM AND 3.0*1.5*0.5 CM. THE SPECIMEN IS AL TAKEN FOR SECTIONS AND LABELED A1-5. FROZEN DX:SOF TISSUE AND LYMPH NODE, LEFT INGUINAL (LN LOWER), 2ND BIOPSY------ NEGATIVE FOR MALIGNANCY. MICRO D:SECTIONS SHOW FIBROUS TISSUE AND THREE LYMPH NODES WITHOUT TUMOR.

想請問各位醫學專家以下幾個問題

Q1:

可否協助敝人說明這三個診斷報告的意義?

希望可以越詳細越好

包括

DX:GROSS D:FROZEN DX:MICRO D:等一些專有名詞

Q2:

這是一種甚麼樣的惡性腫瘤?

這種癌症是不是很嚴重?

這樣已經痊癒了嗎?

以後需要注意甚麼?

Q3:

這種情況是否還要服兵役?

無助的病人 敬上

1 個解答

評分
  • 10 年前
    最佳解答

    Q1: DX:(診斷)SKIN, LEFT INGUINAL, EXCISION---- DERMATOFIBROSARCOMA PROTUBERANS (皮膚,左側鼠蹊部,切除之檢體--隆突性皮部纖維肉瘤)GROSS D:THE SPECIMEN SUBMITTED CONSISTS FO A PIECE OF TISSUE MEASURING 1.7*1.1*1 CM. (外觀: 包含1.7x1.1x1公分的檢體)MICRO D:SECTIONS SHOW SPINDLE TUMOR CELLS AND MILD NUCLEAR ATYPIA WITH INVOLVEMENT OF DERMIS AND SUBCUTIS. THE MARGIN IS INVOLVED.

    (顯微鏡下: 切片當中有梭狀腫瘤細胞,與輕微的核分化不良,並且有表皮與皮下組織的侵犯,邊緣還有腫瘤細胞)

    第二個:DX:SKIN, LEFT INGUINAL, EXCISION---- DERMATOFIBROSARCOMA PROTUBERANS (診斷: 皮膚,左側鼠蹊部,切除得到的檢體- 隆突性皮部纖維肉瘤)GROSS D:THE SPECIMEN SUBMITTED CONSISTS OF ONE PIECE OF SKIN AND UNDERLYING SOFT TISSUE MEASURING 7.5*2.7*1.1 CM. THERE IS A ILL-DEFINED AND FIRM TUMOR MEASURING 1.5*1.4*0.9 CM. THE CUT SURFACES ARE GRAYISH WHITE. THE DEEP MARGIN IS INVOLVED BY THE TUMOR. REPRESENTATIVE SECTIONS ARE TAKEN AND LABELED A TO E ( 外觀上: 檢體包含一片皮膚與皮下的軟組織,大小是7.5x2.7x1.1公分,有邊緣不規則且硬的腫瘤部份,大約1.5x1.4x0.9公分。檢體切面為灰白色,深的邊緣仍然有腫瘤組織,代表性的切片以特別標示在A到E的切片編號當中。) MICRO D:SECTIONS SHOW SPINDLE TUMOR CELLS AND STORIFORM ARRANGEMENT, MILD NUCLEAR ATYPIA WITH INVOLVEMENT OF DERMIS AND SUBCUTIS. THE DEEP SOFT TISSUE MARGIN IS INVOLVED.(顯微鏡下: 切片顯示梭狀細胞腫瘤與打轉型態(storiform)的排列, 輕微的核分化不良,且侵犯到皮膚與皮下。深軟組織邊緣仍有腫瘤細胞)

    第三個:DX:SOF TISSUE AND LYMPH NODE, LEFT INGUINAL (LN LOWER), 2ND BIOPSY------ NEGATIVE FOR MALIGNANCY(診斷: 軟組織與淋巴結,左側鼠蹊部,第二次切片- 沒有腫瘤細胞)GROSS D:THE SPECIMEN CONSISTS OF 2 TISSUE FRAGMENTS MEASURING 6.5*4.5*0.5 CM AND 3.0*1.5*0.5 CM. THE SPECIMEN IS AL TAKEN FOR SECTIONS AND LABELED A1-5.(外觀上: 檢體有兩片組織,量起來是6.5x4.5x0.5公分與3.0x1.5x0.5公分。切片標示為A1-A5)FROZEN DX:SOF TISSUE AND LYMPH NODE, LEFT INGUINAL (LN LOWER), 2ND BIOPSY------ NEGATIVE FOR MALIGNANCY. (冷凍切片(開刀當中做的切片,用來決定下一部開刀的大小): 軟組織與淋巴結-沒有腫瘤細胞)MICRO D:SECTIONS SHOW FIBROUS TISSUE AND THREE LYMPH NODES WITHOUT TUMOR.(顯微鏡下: 有纖維細胞與三個淋巴結,但沒有腫瘤。)

    Q2:

    此為低惡性度的肉瘤,好發於胸部,四肢,或頭頸的真皮及皮下組織,年輕病人較多,若沒有切除乾淨會復發,但極少轉移。

    建議參考http://www.tccf.org.tw/old/magazine/vol15/vol15_m1...

    另外,有無痊癒應該問醫師有無開乾淨,有沒有其他轉移,因為這三片組織切片看不到這樣的結果。以後就是定期回診,定期照胸部X光,注意"局部"與"肺部"有無復發或轉移即可。

    2011-02-15 19:46:37 補充:

    Q3:

    這題我真的不知道答案。

    但看來,只切除皮膚雖然可以拿重大傷病,沒有切除重大器官,我也不確定是否需要當兵,建議你拿著診斷書到鄉鎮市公所兵役課問比較清楚。

    參考資料: 我的腫瘤科
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