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.