Friday, April 8, 2011

Quack, quack, quack

The latest skin biopsy report with all the immunohistology shows all my dense lymphocytes were T cells, no B cells. I saw that one coming. Great news to confirm my clinical impression

It is NOT neoplastic or related to CLL in any way.

And it is almost healed.

It was a bug bite.

Still the over zealous pathologist suggests if there is any lingering concern we still could do more tests for T cell lymphoma. I understand the fear of not missing anything, but as the old saying that everyone hears a million times in medical school goes:

If it quacks like a duck, if it walks like a duck, if it looks like a duck, it is probably a duck.

I had a bug bite.

One comment that I took to heart is that this all could have been avoided if I never saw the dermatologist. After all, Thoreau famously said:

Medicine is the art of amusing the patient while nature takes its course.

Waiting was certainly the right decision in hindsight, and I think I may remain undecided longer the next time something unclear appears. Knowing when to swing the bat and when to watch the pitch is never easy, and I sometimes find myself moving too soon or too late. I will definitely ponder what are the lessons from this wild pitch so that I can continue to improve my batting average. What could I have analyzed differently and reached a different decision?

One thing for sure, I learnt a lot about leukemia in this skin with this unwelcome and unneeded, but not too unpleasant diversion. Moreover, due to the sage advice from a good friend and sharp MD, I really didn't sweat this one too much. It never felt right to worry and consider sinister diagnoses when it all seemed so innocent.

I had a bug bite.

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Anonymous Anonymous said...

thank goodness it was a bug bite, and you didn't go through the sweating it out period of worry over that one.


April 8, 2011 at 8:09 PM  
Anonymous Anonymous said...

I'm glad! Alison.

April 9, 2011 at 1:22 AM  
Anonymous Anonymous said...

quacking good news!
love from sunny and warm London

April 9, 2011 at 6:07 AM  
Anonymous Tom B said...

Glad to hear the good news!!!

April 9, 2011 at 10:58 AM  
Anonymous Anonymous said...

I actually had virtually the same thing happen to me. An alien looking object appeared suddenly on my finger and began to grow. Three physicians looked very grimly at it. Although I am surprisingly robust, I am a heavily treated young CLL patient (51 yo). Final pathology was similar to yours. My reactions to mosquitoes and ticks are pretty unmistakable and horrendous. This thing didn't itch at all. Three months later, I had a dramatic case of "telogen effluvium". From the stress? or was it from some strange totally inappropriate immune system process that produced that strange formation and reset my hair follicles....?

April 10, 2011 at 5:57 PM  

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