In early April this year: neck ultrasound found that left thyroid lesions, in August 1st in a hospital for surgery, intraoperative frozen th
In early April this year: neck ultrasound found that left thyroid lesions, in August 1st in a hospital for surgery, intraoperative frozen thyroid papillary carcinoma of the left lobe, isthmus of the edge of a little cancer cell in three lymph 5/8 carcinoma, 14 were cancer free zone four, at the time of thyroidectomy and left neck lymph node dissection, postoperative pathological examination: right lobe cancer, left paratracheal lymph node 2/3 and left three lymph node metastasis, cancer free zone four, right paratracheal lymph nodes without cancer. Eighth days after stitches, wound healed. Conventional oral euthyrox 100ug, the thyroid function check the normal.8 21 enhanced chest CT scan showed thymus right above a 1.5 x 1.3cm nodular shadows of high density, mild enhancement, and thymus boundary less clear, the root of the neck and left double liquid fossa region showed multiple number of mm size nodular shadows of high density, no obvious enhancement of imaging diagnosis. Fault: mediastinal nodules before, lymph nodes may be considered, left neck lymph node and double liquid display. The doctor can account after college entrance examination next year to do 131 iodine ablation. But now CT examination of the situation, how should I do? What do I do now, what method a check or confirmed mediastinal metastasis after surgery is? What time to do 131 iodine treatment?
Shanghai No.6 People's Hospital, Department of nuclear medicine Chen Libo: 131 iodine ablation can be found on the CT diagnosis or exclusion after January can be done, considering the relatively long distance from Shanghai, may wish to recommend the film scan (or digital camera ah) pass up look
Patient: the hospital doctor advised me to do pat CT, useful? It and iodine 131 treatment and there is a difference, willing to please Dr. Chen
Patient: Professor Chen: from your point of view, do you think it is possible to have lymphatic metastasis? If it is, how to treat to achieve the best results?
Shanghai No.6 People's Hospital Department of nuclear medicine Chen Libo: PET/CT inspection is not eager to do! Should be the best examination is iodine -131 ablation after the whole body imaging, can help determine whether lymph node metastasis or other conditions are recommended to look at the clinic
Patient: Professor Chen, I am a mother of a child, the heart is very want to see your clinic, but the distance, coupled with the children in grade three, just opened the school, the child is very good, we went to the best of the local high school class rocket, a bright future, but do not know their condition please understand our parents seeking eager. I came to the West China Hospital of Sichuan University drove hundreds of kilometers to ask the nuclear medicine professor professor also believes that today, can not do pat CT, told us: following the treatment of thyroid cancer to do 131 iodine ablation sooner or later, no matter whether you are not a metastasis of mediastinal lymph node metastasis and confirmed, you not diagnosed with metastasis, therapy is the same, so when the time is right for examination and treatment of iodine 131. Even if there is a lymph node metastasis, its development is not very fast, not what threat children winter vacation (about the end of December) and iodine 131 treatment, so as not to delay the study. Professor Chen, is that so? I do not understand is: mediastinal lymphatic metastasis can not do surgery? Iodine 131 can be completely cured?
Patient: I carefully read the professor on the website of the popular science articles on thyroid cancer risk score, I do not know mediastinal lymphatic metastasis is not a distant metastasis? Please enlighten
Shanghai No.6 People's Hospital, Department of nuclear medicine Chen Libo: it seems that Huaxi's opinion and is consistent with me: undergoing -131 ablation of iodine your question is, the answer is as follows: 1 mediastinal lymph node metastasis is not clear, I hope to see the image data, to exclude mediastinal thyroid may (diagnosis). 2 lymph node metastasis is not a distant metastasis, because in fact, the root of the neck. 3 surgical indication is not clear, need to combine the image based on the diagnosis of examination, operation methods and risk assessment, we have several successful cases of surgery, if the surgery is clear, we would recommend the preferred surgical treatment. 4 more than 3 points should be determined after iodine -131 treatment. 5 if the transfer is clear, and the diameter of about 1 cm (1.5 x 1.3cm), iodine -131 cure rate of about 70%. Finally, once again suggested that the family with the relevant information to see my expert clinic.
Patient: I was very moved by Professor Chen's dedication and medical parents, I really did not expect to be able to quickly get the professor's advice, thank you very much! Please do Professor don't break and contact us, with your help, my children like to see the life of hope, children's life depends on your help, please! I want to see the other professor Shanghai clinic that, in view of the 60 anniversary of the national day, around the stability maintenance task is arduous, the father of work, can not get away, I want to take care of more than and 80 year old mother and child, not to Shanghai to see you, I will be the children's CT image data recorded a CD together with the recent inspection and please copy medical records with the wind express company courier to you, please to see if there is no problem of mediastinal professor? What advice do you have for us? After the data can be destroyed, I have a backup.
Shanghai No.6 People's Hospital, Department of nuclear medicine Chen Libo: the situation was received, before and after the national day I was not in china. Japanese Society of nuclear medicine should be invited to attend the annual meeting of the country will do a special report: recent advances in diagnosis and treatment of thyroid carcinoma, and to accept the "Young Investigator Award (Asia 2). I am waiting for the express, will do my best to help you!
Patient: Thank you very much! I'll send it tomorrow, and I expect it will be 2--3 days.
Department of nuclear medicine, Shanghai No.6 People's Hospital, Chen Libo
Patient: Professor Chen, I have already sent the data, the earliest tomorrow afternoon, the latest day after tomorrow to the email address of nuclear medicine of Shanghai No.6 People's Hospital, I wrote (Xuhui District Yishan Road 600) Chen Libo, Tel: 021-64369181-8871. So can you receive it?
Shanghai No.6 People's Hospital nuclear medicine Chen Libo: I just returned from the field of consultation, and today received a copy of your express 17:45. Considering that the thymus has not been completely degraded, my experience in this area is somewhat inadequate. The film also caution, she is my wife consultation, Chest Hospital of Shanghai city doctors, have expertise in chest CT diagnosis results, wait. Have a great weekend!
Patient: Professor Chen, I really can not use words to express my gratitude, I deeply feel big medicine sincere love, benevolence, as in a house far xinglin. Hope echo! The child is good, I must thank you personally to Shanghai your wife. I wish you a happy family health.