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View Full Version : My biopsy report....help me read this in english please!



Maegan
05-06-2010, 09:07 AM
so shes saying its consistant with bug bites but there is a question mark before insect bites in the clinical data?

word for word


Diagnosis: Right arm punch: features consistant with arthropod bite reaction, see comment.

Comment: Also included in the histologic differential diagnoses are nonspecific papular urticaria with excoriative changes, urtcarial drug eruption, and urticarial phase of autoimmune bullos disease among possibilities, to be considered only if clinically appropriate

Microscopic description: Multiple sections including deeper levels are examined. There is a central small sharply demarcated focus of necrosis of the epidermisand superficial papillary dermis, with associated netriphils. There is a moderate to mild superficial and deep pervascular lymphocytic infiltrate with eosinophils. PAS stains are negative for fungal organisms. TE:rag

Clinical data: ? insect bite, urtcaria. History of being employed with animals c/o itching and rash mostly on arms and legs.

Gross description: The specimin is recieved fixative and it consists of a skin punch measuring 0.2 cm in diameter and 0.2 cm in depth. the specimen is submitted intact in one cassette, marked 1P. HAM:rc

88312 x1-795.4
88305 x1-795.4

rob
05-06-2010, 11:45 AM
Hi Maegan,

I'll give it a shot...


Diagnosis: Right arm punch: features consistant with arthropod bite reaction, see comment.

This means the symptoms you present with are in the Dr.'s opinion consistent with an allergic reaction to a bug bite.


Comment: Also included in the histologic differential diagnoses are nonspecific papular urticaria with excoriative changes, urtcarial drug eruption, and urticarial phase of autoimmune bullos disease among possibilities, to be considered only if clinically appropriate

The term Differential Diagnoses is a method used to identify the cause of a patients symptoms through the process of elimination. The conditions mentioned such as Autoimmune Bullos Disease are possible alternate causes of your symptoms that they have basically ruled out for the time being unless new clinically appropriate symptoms or indicators develop.


Microscopic description: Multiple sections including deeper levels are examined. There is a central small sharply demarcated focus of necrosis of the epidermisand superficial papillary dermis, with associated netriphils. There is a moderate to mild superficial and deep pervascular lymphocytic infiltrate with eosinophils. PAS stains are negative for fungal organisms. TE:rag

Necrosis of the Epidermis and Superficial Papillary Dermis means there are dead skin cells in the top layer of skin (Epidermis), and the next layer underneath it (Dermis). Neutrophils are the most common type of white blood cell, and are a vital part of the immune system. Their presence can indicate a bacterial infection. Pervascular Lymphocytic Infiltrate means there are white blood cells (Lymphocytes) clustered around blood vessels, usually in response to bacterial infection. Eosinophils are another common type of white blood cell. The Periodic acid Schiff (PaS) stain is a test to determine the presence of a fungal infection.


Clinical data: ? insect bite, urtcaria. History of being employed with animals c/o itching and rash mostly on arms and legs.

Urticaria is simply the medical term for hives


Gross description: The specimin is recieved fixative and it consists of a skin punch measuring 0.2 cm in diameter and 0.2 cm in depth. the specimen is submitted intact in one cassette, marked 1P. HAM:rc

This is a description of the type and format of the skin sample that was tested.


Basically, what I get out of this is they think that you had an allergic reaction to a bug bite that caused hives. Unfortunately I don't know what the question mark in the clinical data means. I've translated the report to the best of my ability, but please keep in mind that I am not a Dr. and some of my info could be inaccurate. Hope this helps.

Rob

Maegan
05-06-2010, 12:56 PM
thank you! well the derm says ALL my hives are bug bites which is rediculous. And they dont know about all my other symptoms, only my rhuemy does. I guess we will see when i go back to the doc

SandyR
05-06-2010, 02:48 PM
thank you! well the derm says ALL my hives are bug bites which is rediculous. And they dont know about all my other symptoms, only my rhuemy does. I guess we will see when i go back to the doc

don't lose hope! I went to a highly recommended dermy once who made me wait almost 2 hours for my appointment (which sent my blood sugar crashing since they insisted I come in that day and it was right at my normal dinner time and I have diabetes) and then the doc walked in, acted all annoyed that I complained about how long I was there when his office insisted I come in that day (I offered to come the next day), glanced at my arm and instantly proclaimed I had uticaria from bed bugs. I even suggested to him "could I be allergic to my allergy medicine since the formulary was changed when it went over the counter" and was laughed off with a no, of course not, it's bed bugs. (BTW - It was the allergy med which I later confirmed with another doctor). No labs, no deep probing looks, no medical history taken. After I insisted that could not be, which it wasn't, he dismissed with a "well that's my opinion and if you don't like it, I would suggest you get another opinion". And I had to be paid to be treated that way!!! Don't give up or lose hope.

sandy

rob
05-06-2010, 03:42 PM
don't lose hope! I went to a highly recommended dermy once who made me wait almost 2 hours for my appointment (which sent my blood sugar crashing since they insisted I come in that day and it was right at my normal dinner time and I have diabetes) and then the doc walked in, acted all annoyed that I complained about how long I was there when his office insisted I come in that day (I offered to come the next day), glanced at my arm and instantly proclaimed I had uticaria from bed bugs. I even suggested to him "could I be allergic to my allergy medicine since the formulary was changed when it went over the counter" and was laughed off with a no, of course not, it's bed bugs. (BTW - It was the allergy med which I later confirmed with another doctor). No labs, no deep probing looks, no medical history taken. After I insisted that could not be, which it wasn't, he dismissed with a "well that's my opinion and if you don't like it, I would suggest you get another opinion". And I had to be paid to be treated that way!!! Don't give up or lose hope.

sandy

Wow, I've known morticians with a better bedside manner than that!

SandyR
05-06-2010, 06:45 PM
rob - needless to say, he is no longer my doctor. :)

Sherry47
05-07-2010, 02:26 AM
I would have paid him a dollar a month till the bill was paid off. What a jerk!