Ohta Ryuichi, Nishikura Nozomi, Sano Chiaki
Communiy Care, Unnan City Hospital, Unnan, JPN.
Community Care, Unnan City Hospital, Unnan, JPN.
Cureus. 2022 Jul 28;14(7):e27415. doi: 10.7759/cureus.27415. eCollection 2022 Jul.
Effectively treating vague symptoms in older adults can be challenging for clinicians. Many vague symptoms will resolve spontaneously with alleviating treatment. Two of the most alarming qualities of symptoms are duration and exacerbation. For primary care and family medicine physicians dealing with vague symptoms in older patients, identifying alarming symptoms and further investigating them can guide their decisions on advanced care directives. We experienced a case of a drastic clinical course of peripheral T-cell lymphoma in a 91-year-old man without specific symptoms or palpable lymphadenopathy on the surface of the body. Clinical observation and prompt pathological investigation were sufficient for diagnosis. However, the patient's hope for home-based palliative care could not be achieved. For vague progressive symptoms in older patients, clinicians should consider the diagnostic process, including perspectives of palliative care, based on the needs of older patients.
对临床医生而言，有效治疗老年人的模糊症状颇具挑战性。许多模糊症状会随着缓解性治疗而自行消退。症状最令人担忧的两个特征是持续时间和病情加重。对于处理老年患者模糊症状的初级保健和家庭医学医生来说，识别令人担忧的症状并进一步调查这些症状可以指导他们在高级医疗指令方面的决策。我们遇到过一例91岁男性外周T细胞淋巴瘤的急剧临床病程，该患者体表无特定症状或可触及的淋巴结肿大。临床观察和及时的病理检查足以确诊。然而，患者居家姑息治疗的愿望未能实现。对于老年患者模糊的进行性症状，临床医生应根据老年患者的需求，考虑诊断过程，包括姑息治疗的观点。
