tag:blogger.com,1999:blog-12660458.post112905044543812524..comments2023-09-01T10:33:09.297-04:00Comments on Pulmonary Roundtable: What would you do next again?Unknownnoreply@blogger.comBlogger5125tag:blogger.com,1999:blog-12660458.post-1129067347887107642005-10-11T17:49:00.000-04:002005-10-11T17:49:00.000-04:00I agree with JH on the point that the slide should...I agree with JH on the point that the slide should be reviewed by an outside pathologist (maybe even send it to the Mayo or maybe send it to Doug hehe). The reason is because there is no clear lesion. However, this could also be because you caught the cancer before it expressed as an overt lesion. But the stakes are high (i.e. resection of whole lobe) and thus that last step of sending it out would be the best approach in my humble opinion.<BR/>I disagree slightly with JH in the sense that it sure as heck smells like a real cancer.<BR/>BTW, as for the link, click on the title (what would you do next again?") and that will take you to the original post.Jenningshttps://www.blogger.com/profile/04930453447603683057noreply@blogger.comtag:blogger.com,1999:blog-12660458.post-1129062340417397672005-10-11T16:25:00.000-04:002005-10-11T16:25:00.000-04:00Actually, the only hyperlink is see is to Jennings...Actually, the only hyperlink is see is to Jennings pulmonary nodule post. <BR/><BR/>In any case- I'm still skeptical of carcinoma, but we have several pathologists reading two different samples taken at different points in time. So, as long as the patient understands that we can not prove that this is benign, I guess I'd refer her for resection. That is the "safest" and most conservative approach, but we've already watched it for a few months, and we still have a reading of possible cancer...Jeff Hhttps://www.blogger.com/profile/01209432708535732499noreply@blogger.comtag:blogger.com,1999:blog-12660458.post-1129059010558398432005-10-11T15:30:00.000-04:002005-10-11T15:30:00.000-04:00BTW, the first findings of squam were on biopsies ...BTW, the first findings of squam were on biopsies not on cytology.Baleeirohttps://www.blogger.com/profile/03993066135160692535noreply@blogger.comtag:blogger.com,1999:blog-12660458.post-1129058908455067252005-10-11T15:28:00.000-04:002005-10-11T15:28:00.000-04:00The title is hyperlinked to the initial post.The title is hyperlinked to the initial post.Baleeirohttps://www.blogger.com/profile/03993066135160692535noreply@blogger.comtag:blogger.com,1999:blog-12660458.post-1129057246317372702005-10-11T15:00:00.000-04:002005-10-11T15:00:00.000-04:00Can you link this back to the initial case? I thi...Can you link this back to the initial case? I think I remember the details, but wanted to be sure.<BR/><BR/>I'm still skeptical of carcinoma in this case, but I think you have to have a discussion with the patient. Either you can say "you have good PFT's, we should take out the LLL", or propose more short term follow up. Cytology is tricky, and in this case you may want to send the slides to an outside consulting pathologist. <BR/><BR/>I think I'd still favor short term follow up after some empiric antibiotics and continued anti-inflammatories, as it sounds like the previous abnormality resolved...but, I would offer referral for a lobectomy without hesitation if the patient was leaning that way.<BR/><BR/>This is a tough one...Jeff Hhttps://www.blogger.com/profile/01209432708535732499noreply@blogger.com