|
I need help please
This is some reports about my wife
She can't make more testing like open lung biopsy it's impossible.
I'd like to know if my wife has lymphoma, and if so, which type
We need to take appropriate actions.
Please reply to me. My wife can't walk 5 steps at the same room and she live with 7 liters oxygen 24 hour a day if she move
about 5 steps the oxygen level will be less than 50 .
X- RAY REPORT
9-11-2009
Chest Radiograph ( PA View ) Revealed :-
Both lung fields show multiple reticulonodular infiltration
Giving honey comb appearance with tendency to cystic changes for correlation with clinical data end previous films.
Pathology Report
Material: C.T. guided fine needle aspiration cytology (FNAC) of a lung nodule & liver focal lesions.
Date of aspiration: 24/11/2009
CLINICAL PICTURE:
C.T. guided fine needle aspiration cytology (FNAC) of a lung nodule & liver focal lesion smeared over eight
slides.
MICROSCOPY:
Cellular lung smears formed of many groups of epitheloid cells having large nuclei and abundant esinphilic
cytoplasm. Many groups of hyperplastic bronchial cells exhibiting mild-moderate atypia were detected. The background was
infiltrated with chronic inflammatory ceels mainly lymphocytes with moderate number of uniuncleated histiocytes. Few
multinucleated giant cells were observed.
The liver aspirate showed many groups of liver cells having bland cntral nuclei over background having
infiltrated with lymphocytes.
DIAGNOSIS:
LUNG NODULE & LIVER FOCAL LESION: C.T. guided Fine Needle Aspiration Cytology (FNAC)
Lymphoroliferative disorder suggestive for granulomatous inflammation for immunophenotyping confirmation.
PATHOLOGY REPORT
Microscopic:
Examination of the films received many red cells, many scattered small, intermediate and large lymphoid cells with very few
polmonuclear leucocytes.
Diagnosis:
Lung nodule and liver focal lesions, FINDING ARE IN FAVOUR OF MALIGNANT LYMPHOMA.
-CASE FOR TISSUE BIOPSY FOR IMMUNOPHENOTYPING.
PATHOLOGY REPORT
GROSS:
- Referred 8 FNAC smear slides, labeled by patient's name. four of the slides are labeled for site as liver and the
other 4 as lung. All slides are examined and re-enclosed.
- Three of the slides are de-stained after routine examination, then immunostained for LCA. CK & NSE.
MICROSCOPY:
- Liver and lung FNAC smears show blood and scattered groups of small, medium and large round cells. The FNAC smears
also rich in neutrophils.
- The immunostained smears show negative staining for CK & NSE and positive staining for LCA.
Conclusion:
Cytology slides ; re-staining for immunophenotyping:
FINDINGS ARE CONSISTENT WITH NON-HODGKIN'S LYMPHOMA ; MIXED SMALL AND LARGE CELL.
PATHOLOGY REPORT
One of the referred FNAC smear slides is de-stained after routine
Examination, then immunostained for CD 20 as requested
MICROSCOPY
The immunostained smear shows a majority of CD 20 –megative cells and few – likely reactive- positively stained
small lymphocytes.
CONCLUSION:
Cytology slides ; restining for CD 20
Most cells are CD 20 negative. Scattered positive (likely reactive) small lymphocytes.
Complete Blood Count Ref. Range
Haemoglobin 5.6 gm/dl 12.1-16.6
Haematocrit 20.0% 30-40
Red cells count 3.37 mil/cmm 4.2-5.4
Red cell indices
MCV 59.3 fl 78-94
MCH 16.6 pg 26-32
MCHC 28.0 gm/dl 31-34
RDW 20.9%
Total leucocytic count 11,900 /cmm 4,000-11000
Differential Count
Basophils 0 % 0-1
Eosinophils 1 % 1-4
Staff 2 % 1-7
Segmented 68 % 40-75
Lymphocytes 23 % 20-45
Monocytes 6 % 1-8
Others
Platelet Count 800,000 /cmm 150,000-450,000
All the best,
|
