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Clinical diagnosis answers (5865)

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	Q: What is a clinical diagnosis? A: A clinical diagnosis is based on the medical history and physical examination of the patient ...... Add your question · Add your comment · Answer to this question
	Q: Multiple Sclerosis by clinical diagnosis A: Hi, Thanks for the query. I will answer it according to the question numbers. 1)Multiple sclerosis is a neurological disorder usually seen in individuals between 20-50 years of age. It most commonly presents itself with visual disturbances, along with limb weakness, muscle spasms and tremors (which you are experiencing), but the diagnosis is purely clinical and needs a detailed history. 2)As I mentioned earlier, it is a mainly clinical diagnosis that can be supported by investigations like an MRI, an EEG, and with a CSF analysis. 3)Your problems seem neurologically related, hence a detailed neurological examination may be helpful for you. Any qualified neurologist will be able to help you.... Add your question · Add your comment · Answer to this question
	Q: My clinical diagnosis states states ''proven ductual cancer in situ with microinvasion solid type high nuclear grade. The summary of major pathological diagnoses states ''invasive ductal carcinoma, 2.2cm, tumor grade 3 (tubule 3, nuclear pleomorphism 3, mitotic count 2, nuclear grade 3, lymphovascular invasion absent, perineural invasion absent, necrosis absent, nodes clean, intraductual component 80%, histologic type: solid, cribriform, high grade. multi focal areas of in-situ carcinoma absent, multifocal areas of invasive absent, tumor fibrosis slight, estrogen/progest. negative. I had a bi-lateral mastecomy. My oncologist is recommending 4 A/C and 4 Taxol treatments, dose dense (every two weeks) and calling this a stage 2A tumor. Do you agree with this or think I should get a second opinion on chemo treatment. Is that fact that it is 80% intraductal a plus for me as I know the estrogen negative is not good. How had is the estrogen negative status in regard to treating this or it''s distant recurring status based on tumor size. It it based on the whole tumor size or just the invasive part as far as likelihood of distant mets? Thanks so much for your help. A: the need for chemo is based on size of the invasive component, the grade, lymph node involvement or not, angiolymphatic invasion or not, patients age, and hormone receptors. what you describe is very common recommendation. there are a variety of chemo choices though and for that consider a second opinion to review them all.... Add your question · Add your comment · Answer to this question clinical diagnosis related terms: tumor grade · necessary component · nuclear grade · focal areas · clinical diagnosis related drugs: idarubicin · docetaxel · Trexall ·
	Q: My final diagnosis of a recent core needle biopsy follows: ''Breast, Right, 6 o''clock position, core needle biospsy:Intraductal Papilloma.'' clinical INFORMATION:''46 yr-old female with nonpalpable solid 1 cm size mass lesion in the 6 o''clock position of the lower quadrant of the right breast, detected by imaging. The specimen was obtained via ultrasound guided needle core biopsy. The patient is not currently pregnant or nursing and her family history is negative for breast cancer.'' clinical diagnosis: ''?fibroadenoma vs carcinoma.'' GROSS DESCRIPTION: '' ''Right breast 6 o''clock,'' is yellow-tan pices, and the aggregate ia 15x13x1 mm, filtered, one cassette.'' MICROSCOPIC DESCRIPTION: ''Sections of segments of breast tissue do show presence of an intructal papilloma. Foci of Sclerosis and hyalinization are present. Within the papilloma proper there are foci of apocrine metaplasia. There are rare to occasional scattered microcalcifications within the ductal lumina that are part of this papilloma, and a portion of the sclerotic stroma also shows dystrophic calcification. There is no evidence for malignancy in the sections available for evaluation.'' MY QUESTIONS: My understanding is that a common symptom of Intraductal Papilloma is discharge from the nipple, yet I have never had this symptom. Is this unusual? Why the question mark in the clinical diagnosis? I''m scheduled to see a surgeon in 3 weeks. If I were your mother, would you suggest surgical removal of the papilloma? Any other insight you might have regarding this diagnosis? Thank you so very much for your feedback. A: surgical removal is the standard of care for papillomas. and they don''t always cause nipple discharge. usually what happens is someone has bloody nipple discharge and it is found to be caused by a papilloma. sounds like they want more tissue anyway to confirm this is benign.... Add your question · Add your comment · Answer to this question clinical diagnosis related terms: final diagnosis · mass lesion · intraductal papilloma · gross description ·
	Q: My Husband Was clinicalLY DIAGNOSED With Muscular Dystrophy? Is A clinical diagnosis An Actual diagnosis? A: Yes, it means the results were found by laboratory testing.... Add your question · Add your comment · Answer to this question clinical diagnosis related terms: clinically diagnosed · how is muscular dystrophy diagnosed? ·
	Q: 1) Right Tissue Mass: Breast tissue shows Multiple foci of ductal carcinoma IN SITU (dcis) Papillary and solid papillary type and of moderate to high nuclear grade. Foci of lobular cancerization are present. There is no evidence of microinvasion. DCIS is present in 12 of 68 slides (12/68) and is present at super surgical margin. DCIS is with 0.1 cm of anterior and posterior margins. The rest of the breast tissue showing multiple intraductal papollomas, usual ductal hyperplasia, adenosis, cysts, and duct ectasia. Areas of hemmorrhage and granulation tissue are seen, consistent with prior biopsy procedure. 2)clip Metallic clip. gross only CAP protocol specimem type : Lumpectomy Lymph Node sampling: no lymph node sampling specimen size: 9x9x1.5cm Laterality Right Tumor site: not specified Histologic Type: Ductual carcinoma in situ, papillary and solid papillary type of moderate to high nuclear grade. Microinvasion: not present Pathologic staging pTis, pNX Margins:DCis is present at superior margin and within 0.1cm of anterior and posterior margins. ER/PR studies sent. Page 2 clinical diagnosis Right Breast Mass clinical Information os Tissue Sumitted Part 1 right breast mass part 2 clip Gross 1) The specimen is received in the fresh state, labeled with the patients name and accession number as ''right Breast mass with needle Localization'', and consist of 9 x 9 1.5 cm lobulated portion of soft yellow-tan breast parenchyma with accompanying x-ray. localization wires present in situ, and attached sutures indicating the superior and lateral margins as per the requisition. The sugical margins are inked as follows: superior=black, inferior=blue,medial=red, lateral=green,anterior=yellow, posterior=orange. Serial section reveal soft lobulated yellow-tan fibrofatty tissue containing dilated ducts with inspissated material and ill-defined nodular gray white fibrous areas. entirelt submitted 68 casssettes page 3 Gorss Section are submitted as follows A-N :Superior breast O-AB: inferior breast AC-AN: medical breast AO-AW: Lateral Breast AX-BF: Anterior breast BG-BP: posterior Breast Gross Deion 2) the specimen is received in its natural sate, labled with patients name and accession number as ''CLIP'', and consists of a 0.3x 0.1 cm metal. No tissue submitted ADDENDUM Prognostic INDICATOR STUDIES PERFORMED USING PARAFFIN I BG RIGHT BREAST/PARAFFIN HORMONAL RECEPTORS ARE STAINED WITH MONOCLONAL ANTIBODIES TO ESTROGEN RECEPTORS ( ER1D5) AND PROGESTERONE RECEPTORS (PGR 636, DAKO) VISUAL EVALUATION : INSITU CARCINOMA ESTROGEN RECEPTORS: PERCENTAGE OF POSITIVE CELLS -75% INTENSITY OF nUCLEAR STAINING : 2+ pROGESTERONE RECEPTORS: PERCENTAGE OF POSTIVE CELLS THERE A GREATER THAN SIGN( BUT CANT FIND THE BUTTON ON COMPUTER) 90% iNTENSITY OF NUCLEAR STAINING 3+ THEN IT SAYS IN TINY WRITING Other diagnostic reports 1)505 53006 11/30/05 breast , right nipple discharge,: smear negative for malignant cells rare small clusters of epithelial cells , macrochages, lymphocytes and thick amorphous proteinaceous material.Hi again...............My doctor want a Breast specific gamma imaging test. Why I have no idea. She say to get better idea where cancer cells are. Then she said i need a Lumpetumy with a sentinel node biopsy. I want what ever is simple. Does this sound right to u. I want a lumpectomy , rads and the tomoxifin and then to get on with my life. Does my pathology report, support my doing this..... I undertand if node come back positive things will be diferent..... I just want to know what you think of my lupmectomy, rads and tomoxifin , is that fesable with my path finding.. oh oh are my margin there for my suregeon to go in and get a clean margin... I see the path says soemhtign about margins.. Is this helpful in my case to get clear margins...Oh thanks againGina A: clear margins are imperative. if the breast still looks cosmetically good right now then the doctor might consider re-excision. the challenge here is not knowing how ''multifocal'' the disease is... if it is tracking up and down the ductal a long way then usually mastectomy with reconstruction is recommended instead. if you want to come here for a second opinion about it just call 443-287-2778. without a lot more information there is no way to guess. it would require a consultation.... Add your question · Add your comment · Answer to this question clinical diagnosis related terms: prognostic indicator · monoclonal antibodies · granulation tissue · tissue mass · clinical diagnosis related drugs: Idamycin PFS · bevacizumab · Trexall ·

	Q: My final diagnosis of a recent core needle biopsy follows: ''Breast, Right, 6 o''clock position, core needle biospsy:Intraductal Papilloma.'' clinical INFORMATION:''46 yr-old female with nonpalpable solid 1 cm size mass lesion in the 6 o''clock position of the lower quadrant of the right breast, detected by imaging. The specimen was obtained via ultrasound guided needle core biopsy. The patient is not currently pregnant or nursing and her family history is negative for breast cancer.'' clinical diagnosis: ''?fibroadenoma vs carcinoma.'' GROSS DESCRIPTION: '' ''Right breast 6 o''clock,'' is yellow-tan pices, and the aggregate ia 15x13x1 mm, filtered, one cassette.'' MICROSCOPIC DESCRIPTION: ''Sections of segments of breast tissue do show presence of an intructal papilloma. Foci of Sclerosis and hyalinization are present. Within the papilloma proper there are foci of apocrine metaplasia. There are rare to occasional scattered microcalcifications within the ductal lumina that are part of this papilloma, and a portion of the sclerotic stroma also shows dystrophic calcification. There is no evidence for malignancy in the sections available for evaluation.'' MY QUESTIONS: My understanding is that a common symptom of Intraductal Papilloma is discharge from the nipple, yet I have never had this symptom. Is this unusual? Why the question mark in the clinical diagnosis? I''m scheduled to see a surgeon in 3 weeks. If I were your mother, would you suggest surgical removal of the papilloma? Any other insight you might have regarding this diagnosis? Thank you so very much for your feedback A: surgical removal is the standard of care for papillomas. and they don''t always cause nipple discharge. usually what happens is someone has bloody nipple discharge and it is found to be caused by a papilloma. sounds like they want more tissue anyway to confirm this is benign.... Add your question · Add your comment · Answer to this question
	Q: Final diagnosis 1) Right Tissue Mass: Breast tissue shows Multiple foci of ductal carcinoma IN SITU (dcis) Papillary and solid papillary type and of moderate to high nuclear grade. Foci of lobular cancerization are present. There is no evidence of microinvasion. DCIS is present in 12 of 68 slides (12/68) and is present at super surgical margin. DCIS is with 0.1 cm of anterior and posterior margins. The rest of the breast tissue showing multiple intraductal papollomas, usual ductal hyperplasia, adenosis, cysts, and duct ectasia. Areas of hemmorrhage and granulation tissue are seen, consistent with prior biopsy procedure. 2)clip Metallic clip. gross only CAP protocol specimem type : Lumpectomy Lymph Node sampling: no lymph node sampling specimen size: 9x9x1.5cm Laterality Right Tumor site: not specified Histologic Type: Ductual carcinoma in situ, papillary and solid papillary type of moderate to high nuclear grade. Microinvasion: not present Pathologic staging pTis, pNX Margins:DCis is present at superior margin and within 0.1cm of anterior and posterior margins. ER/PR studies sent. Page 2 clinical diagnosis Right Breast Mass clinical Information os Tissue Sumitted Part 1 right breast mass part 2 clip Gross 1) The specimen is received in the fresh state, labeled with the patients name and accession number as ''right Breast mass with needle Localization'', and consist of 9 x 9 1.5 cm lobulated portion of soft yellow-tan breast parenchyma with accompanying x-ray. localization wires present in situ, and attached sutures indicating the superior and lateral margins as per the requisition. The sugical margins are inked as follows: superior=black, inferior=blue,medial=red, lateral=green,anterior=yellow, posterior=orange. Serial section reveal soft lobulated yellow-tan fibrofatty tissue containing dilated ducts with inspissated material and ill-defined nodular gray white fibrous areas. entirelt submitted 68 casssettes page 3 Gorss Section are submitted as follows A-N :Superior breast O-AB: inferior breast AC-AN: medical breast AO-AW: Lateral Breast AX-BF: Anterior breast BG-BP: posterior Breast Gross Description 2) the specimen is received in its natural sate, labled with patients name and accession number as ''CLIP'', and consists of a 0.3x 0.1 cm metal. No tissue submitted ADDENDUM Prognostic INDICATOR STUDIES PERFORMED USING PARAFFIN I BG RIGHT BREAST/PARAFFIN HORMONAL RECEPTORS ARE STAINED WITH MONOCLONAL ANTIBODIES TO ESTROGEN RECEPTORS ( ER1D5) AND PROGESTERONE RECEPTORS (PGR 636, DAKO) VISUAL EVALUATION : INSITU CARCINOMA ESTROGEN RECEPTORS: PERCENTAGE OF POSITIVE CELLS -75% INTENSITY OF nUCLEAR STAINING : 2+ pROGESTERONE RECEPTORS: PERCENTAGE OF POSTIVE CELLS THERE A GREATER THAN SIGN( BUT CANT FIND THE BUTTON ON COMPUTER) 90% iNTENSITY OF NUCLEAR STAINING 3+ THEN IT SAYS IN TINY WRITING Other diagnostic reports 1)505 53006 11/30/05 breast , right nipple discharge,: smear negative for malignant cells rare small clusters of epithelial cells , macrochages, lymphocytes and thick amorphous proteinaceous material. If I have a lumpetomy, will I need a snb too? I swear I heard my surgeon said I need one. Is this a precautionary measure.Also, how painful is it to get the dye injected and then how long do I have to wait to go into surgery? Thank you so much for ths wonderful site. You are a blessing A: no sentinel node biopsy needed with a lumpectomy for DCIS because DCIS is noninvasive disease. it would be done if a mastectomy was done, just a precaution if the pathologist found any invasive cells realizing that the breast would be ''gone'' and no way to find the sentinel node later. 2 margins are close-- so re-excision probably is planned. hormone receptors positive. all good news.... Add your question · Add your comment · Answer to this question
	Q: 1) Right Tissue Mass: Breast tissue shows Multiple foci of ductal carcinoma IN SITU (dcis) Papillary and solid papillary type and of moderate to high nuclear grade. Foci of lobular cancerization are present. There is no evidence of microinvasion. DCIS is present in 12 of 68 slides (12/68) and is present at super surgical margin. DCIS is with 0.1 cm of anterior and posterior margins. The rest of the breast tissue showing multiple intraductal papollomas, usual ductal hyperplasia, adenosis, cysts, and duct ectasia. Areas of hemmorrhage and granulation tissue are seen, consistent with prior biopsy procedure. 2)clip Metallic clip. gross only CAP protocol specimem type : Lumpectomy Lymph Node sampling: no lymph node sampling specimen size: 9x9x1.5cm Laterality Right Tumor site: not specified Histologic Type: Ductual carcinoma in situ, papillary and solid papillary type of moderate to high nuclear grade. Microinvasion: not present Pathologic staging pTis, pNX Margins:DCis is present at superior margin and within 0.1cm of anterior and posterior margins. ER/PR studies sent. Page 2 clinical diagnosis Right Breast Mass clinical Information os Tissue Sumitted Part 1 right breast mass part 2 clip Gross 1) The specimen is received in the fresh state, labeled with the patients name and accession number as ''right Breast mass with needle Localization'', and consist of 9 x 9 1.5 cm lobulated portion of soft yellow-tan breast parenchyma with accompanying x-ray. localization wires present in situ, and attached sutures indicating the superior and lateral margins as per the requisition. The sugical margins are inked as follows: superior=black, inferior=blue,medial=red, lateral=green,anterior=yellow, posterior=orange. Serial section reveal soft lobulated yellow-tan fibrofatty tissue containing dilated ducts with inspissated material and ill-defined nodular gray white fibrous areas. entirelt submitted 68 casssettes page 3 Gorss Section are submitted as follows A-N :Superior breast O-AB: inferior breast AC-AN: medical breast AO-AW: Lateral Breast AX-BF: Anterior breast BG-BP: posterior Breast Gross Description 2) the specimen is received in its natural sate, labled with patients name and accession number as ''CLIP'', and consists of a 0.3x 0.1 cm metal. No tissue submitted ADDENDUM Prognostic INDICATOR STUDIES PERFORMED USING PARAFFIN I BG RIGHT BREAST/PARAFFIN HORMONAL RECEPTORS ARE STAINED WITH MONOCLONAL ANTIBODIES TO ESTROGEN RECEPTORS ( ER1D5) AND PROGESTERONE RECEPTORS (PGR 636, DAKO) VISUAL EVALUATION : INSITU CARCINOMA ESTROGEN RECEPTORS: PERCENTAGE OF POSITIVE CELLS -75% INTENSITY OF nUCLEAR STAINING : 2+ pROGESTERONE RECEPTORS: PERCENTAGE OF POSTIVE CELLS THERE A GREATER THAN SIGN( BUT CANT FIND THE BUTTON ON COMPUTER) 90% iNTENSITY OF NUCLEAR STAINING 3+ THEN IT SAYS IN TINY WRITING Other diagnostic reports 1)505 53006 11/30/05 breast , right nipple discharge,: smear negative for malignant cells rare small clusters of epithelial cells , macrochages, lymphocytes and thick amorphous proteinaceous material.Hi again...............My doctor want a Breast specific gamma imaging test. Why I have no idea. She say to get better idea where cancer cells are. Then she said i need a Lumpetumy with a sentinel node biopsy. I want what ever is simple. Does this sound right to u. I want a lumpectomy , rads and the tomoxifin and then to get on with my life. Does my pathology report, support my doing this..... I undertand if node come back positive things will be diferent..... I just want to know what you think of my lupmectomy, rads and tomoxifin , is that fesable with my path finding.. oh oh are my margin there for my suregeon to go in and get a clean margin... I see the path says soemhtign about margins.. Is this helpful in my case to get clear margins...Oh thanks againGina A: clear margins are imperative. if the breast still looks cosmetically good right now then the doctor might consider re-excision. the challenge here is not knowing how ''multifocal'' the disease is... if it is tracking up and down the ductal a long way then usually mastectomy with reconstruction is recommended instead. if you want to come here for a second opinion about it just call 443-287-2778. without a lot more information there is no way to guess. it would require a consultation.... Add your question · Add your comment · Answer to this question
	Q: my results from my biopsy reads... clinical diagnosis- U/S guided bx fro retroareolar microcalcifications actually visualized on U/S. (1st seen on Mammogram)Final diagnosis after core biopsy...A rare very small calcification is identified on multiple serial sections. This is likely too small to have been visualized. There is no evidence of malignancy or ADH.Ore Biopsies: Fibrocystic chang/fibrosclerosis negative for malignancy. PAS-4.Not sure what all of this means. Did they get the right area? I have a family history of BC (mother. If the cluster of microcalcs were too small to be seen on U/S, then what calcifications did she biopsy? I am anxious for follow up mammogram. Am I at higher risk for BC? should I be watched every 6 months? A: results were benign then. they should have xrayed the specimen before sending it to pathology to ensure that the correct area was in fact biopsied. ask about this.... Add your question · Add your comment · Answer to this question

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