Surgery Godfather
Chapter 1091 - 887 The Truth Revealed_2

Chapter 1091: Chapter 887 The Truth Revealed_2

This case, Yang Ping was determined to clarify.

When it came to the matters Yang Ping entrusted, Director Fang acted with speed and efficiency. He called over at Affiliated Hospital No. 4 and asked a friend for help. It turned out that indeed there was no pathology report in the medical records, and the Pathology Department’s computer database did not contain a pathology report for this patient.

Two surgeries without a pathology report? Coupled with Director Qian’s resounding reputation, Director Fang began to feel an ominous premonition.

Since Affiliated Hospital No. 4 did not have a pathology report, the next step was to search the county hospital. Director Fang had good relations with peers in the province, after all, Sanbo Hospital was a provincial hospital, with many doctors coming each year for further education. He contacted Dr. Gu from the General Surgery Department of Zhongqiao County People’s Hospital, where Nong Tiesheng was initially diagnosed. Dr. Gu had done his training under Director Fang, who was often invited by him to perform surgeries.

Dr. Gu helped to search through the hospital’s computer system, and then borrowed the electronic medical records of this patient. The patient had previously undergone a thyroid surface ultrasound and a thyroid fine-needle aspiration biopsy. Director Fang immediately asked Dr. Gu to photocopy the pathology report and to also help retrieve the pathology slices, and then find a way to send these two items to Sanbo Hospital.

Dr. Gu was very efficient, not only obtaining the pathology report and the pathology slices from that time but also photocopying the entire set of medical records and immediately driving them to the provincial city to hand over to Director Fang.

Having obtained the pathology slices, pathology report, and the full set of medical records, Yang Ping was delighted because there were too many contradictions in the case that led him to doubt things he shouldn’t have doubted.

After reviewing the full set of medical records from Zhongqiao County People’s Hospital, Yang Ping roughly sorted out Nong Tiesheng’s medical treatment history.

The county hospital’s surface ultrasound report suggested a thyroid adenocarcinoma was considered, recommending a combination of clinical and pathological evaluations. The ultrasound physician’s rationale was sufficient: the height of the thyroid nodule was greater than its width, and it had characteristics of microcalcification and reduced blood supply.

The Zhongqiao County People’s Hospital’s pathology report stated: Thyroid adenocarcinoma was considered, due to unsatisfactory biopsy sample—seen with a large amount of blood and serous components, it is recommended to retake the specimen.

Both of these reports were described in the medical records from Affiliated Hospital No. 4. The admission records contained detailed descriptions of the current illness and auxiliary examinations, including the timing, results, and identification numbers of the tests—a very well-organized approach.

So, it appeared that Affiliated Hospital No. 4’s diagnosis of thyroid cancer was based on these two reports. However, as a higher-level hospital, shouldn’t they have retaken the samples for review? Moreover, after two surgeries, shouldn’t the resected tumors have been sent for pathological examination? Were they really diagnosing and treating for thyroid cancer based only on this report?

"I will personally examine the pathology slices."

Yang Ping said to Director Fang and immediately called Wen Ruzheng from the Pathology Department. Then, along with Director Fang, Dr. Gu, and the pathology slices, he went to the Pathology Department.

Because Dr. Gu had to take the pathology slices back with him, he also accompanied them.

After looking at the pathology slices through a microscope in the Pathology Department, Yang Ping pondered for a while. Indeed, the sample preparation for the pathology slices was substandard, not meeting the criteria for judgment. However, there were still a few cells that could be observed on the slices. Other doctors might find it difficult to draw conclusions, but for Yang Ping, those were enough for a decision. It was not thyroid adenocarcinoma, but rather a rare type of thyroid colloid nodule that could easily be confused with thyroid cancer.

Now, without the original ultrasound images on hand, Yang Ping could have made a very definitive judgment, if only he knew whether the ultrasound physician at the county hospital had kept the images.

The images printed on the current ultrasound report were extremely blurry, rendering them practically meaningless and only symbolic.

"Is there any way to find the original ultrasound images from Zhongqiao County?" Yang Ping asked Director Fang beside him.

Without full confidence and solid evidence, Yang Ping was hesitant to make a statement now, for his words would overturn all the previous diagnoses and treatments—a matter of utmost seriousness that required prudence.

"I can go ask," said Dr. Gu, who had delivered the documents.

However, looking at the signature on the ultrasound report, Dr. Gu noted that the ultrasound physician had already left the position and was working at a private hospital in the provincial city. Dr. Gu had no choice but to ask another physician from the ultrasound department to help look up the original ultrasound images of the patient.

Fortunately, another physician quickly found Nong Tiesheng’s ultrasound images and promised to find a way to transmit them over.

Because the hospital didn’t allow the use of USB drives, the Surface Ultrasound Doctor could only burn the data onto a CD, then find a place to process the images on the CD and upload them to a cloud drive.

Director Fang wasn’t performing surgery and specifically came to handle this matter, taking Dr. Gu for lunch near the hospital. They ate while waiting for the transfer of the images, the whole process being extremely troublesome, but to clarify everything, it was necessary, as it concerned the patient’s entire life.

If it weren’t for cancer, carrying the weight of cancer for a lifetime is unimaginable.

Around three in the afternoon, the Surface Ultrasound Doctor finally found a young doctor who helped with the conversion and transfer of the images, storing them in a cloud drive and giving Dr. Gu the username and password to view them himself.

Just then, Yang Ping had just finished surgery. He hadn’t even taken off his scrubs and just threw a white gown over them as he left the operating room.

In the Surgical Research Institute, Yang Ping’s office had two computers, one connected to the external network and one not.

Using the computer connected to the external network, Yang Ping pulled up the hard-earned Surface Ultrasound images and carefully reviewed each frame. He breathed a sigh of relief.

However, he didn’t express his opinion on the spot, because Dr. Gu from Zhongqiao County was present. This matter was delicate and, no matter how skilled he was, his was still just one opinion. He didn’t want his comments to spread yet, as there were many details to be cleared up, such as the initial absence of a pathological examination at Affiliated Hospital No. 4.

Dr. Gu’s task was completed, and he had to work the next day, so he hurried back with the pathology slices. Director Fang returned the slices to him for archiving. As he was leaving, Dr. Gu realized that the young doctor who had been showing him the Surface Ultrasound images that day was none other than the legendary Yang Ping. What an honor it was.

With the aura of having published numerous papers in CNS, Yang Ping truly seemed like a god among these doctors.

After Dr. Gu left, only Yang Ping and Director Fang were in the office. Yang Ping said seriously,

"This is not thyroid cancer. The Surface Ultrasound images show bilateral signs, meaning there’s a low-echo rim surrounding the high-echo mass, which is a typical presentation of zombie nodules; combined with the descriptions from several medical records, Nong Tiesheng’s entire onset of the disease involved the thyroid nodule remaining unchanged, suddenly growing, and then suddenly shrinking. These changes are often seen in thyroid nodules undergoing cystic changes or hemorrhage. The glandular tissue of the thyroid is generally quite loose. So if there is cystic change or hemorrhage inside, after some time, the cystic wall or solid tissue is likely to collapse, the internal fluid gets absorbed by the gland, and the solid tissue collapses, eventually forming an irregular, low-echo, solid nodule. Some nodules are taller than they are wide, and the concentrated colloid inside can easily be misdiagnosed as microcalcifications. Thus, after absorption, the Surface Ultrasound images can be easily confused with papillary thyroid carcinoma."

"So the initial Surface Ultrasound considered it papillary thyroid carcinoma!"

"This type of thyroid zombie nodule is relatively rare and easily leads to misdiagnosis."

This is the most primitive information. Integrating all of these initial objective examination data, the truth is now clear: the patient doesn’t have thyroid cancer but a zombie nodule instead.

This way, linking these initial data with all the subsequent examinations conducted at Affiliated Hospital No. 4 makes sense – why later all the tests there did not indicate thyroid cancer.

"So that’s how it is!"

Director Fang took a deep breath.

But why didn’t the doctors review the diagnosis at that time? Why was there no pathological report after the surgery? Or why, based on that diagnosis, diagnosed as thyroid cancer and then proceeded to perform radical surgery, followed by radiotherapy and targeted therapy?

This doesn’t seem like the procedural style of a higher-level hospital, unless---

Fuck!

Director Fang cursed as he realized something.