Understanding Pathology report

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Teddybear
Posts: 24
Joined: Sun Feb 11, 2018 3:23 pm

Understanding Pathology report

Postby Teddybear » Mon Mar 05, 2018 12:04 pm

Hi All. Recovering from resection and received pathology report. Doctor was less than helpful understanding it. I would appreciate any opinions/insight into a T3, No/Mo/G2 -mod differentiated that went just into the subserosal adipose tissue. It also said carcinoma distance from closest margin was 2 cm , that sounds really close!

Wishing everyone a blessed and healthy day. :)
DX CC Feb 2018
Feb 2018 Lap sigmoind resection
2A
T3N0M0/G2
0/14 nodes
no invasion
Margins clear
MSS
April 2018 Xeloda

User avatar
Atoq
Posts: 187
Joined: Wed Oct 25, 2017 9:31 am

Re: Understanding Pathology report

Postby Atoq » Mon Mar 05, 2018 12:44 pm

I think the safe distance is 2 mm, so 2 cm is really good. At the micro scala which is the cells scala, 2 cm is a huge distance.

Claudia
45 year old, mother of 2
Dx rectal cancer October 2017
At least T3N2aMX (suspect metastasis to one lung 8 mm)
Lynch negative
Neoadjuvant chemoradiotherapy Xeloda + 25x2 Gy
05.12.17 laparotomic surgery for blockage, colostomy
25.01.18 laparotomic lar, hysterectomy, ileostomy
05.03.18 core needle biopsy of lung, updated to stage IV
07.05.18 CAT scan, lung metastasis 11 mm
04.06.18 ileostomy reversal scheduled

Teddybear
Posts: 24
Joined: Sun Feb 11, 2018 3:23 pm

Re: Understanding Pathology report

Postby Teddybear » Mon Mar 05, 2018 1:05 pm

I appreciate you clearing that up for me. Good luck and wishing you a healthy Easter.
DX CC Feb 2018
Feb 2018 Lap sigmoind resection
2A
T3N0M0/G2
0/14 nodes
no invasion
Margins clear
MSS
April 2018 Xeloda

Caat55
Posts: 345
Joined: Sat Dec 23, 2017 6:01 pm

Re: Understanding Pathology report

Postby Caat55 » Mon Mar 05, 2018 8:47 pm

This was shared with me when I got my pathology report.

O Stoma Mia wrote:

Here's a typical path report template:

Path Report Template

Table 2
Surgically resected specimens of colorectal cancer – Checklist

Tumor site:
Cecum
Ascending colon
Hepatic flexure
Transverse colon
Splenic flexure
Descending colon
Sigmoid colon
Rectosigmoid junction
Rectum

Tumor size
Maximum tumor diameter: cm

Histologic type
Adenocarcinoma
Mucinous adenocarcinoma
Signet-ring cell carcinoma
Small cell carcinoma
Squamous cell carcinoma
Adenosquamous carcinoma
Medullary carcinoma
Undifferentiated carcinoma
Other (specify):

Grade of differentiation
Low grade (well or moderately differentiated)
High grade (poorly differentiated or undifferentiated)
High grade component (%):

Depth of tumor invasion
No evidence of primary tumor
Tumor invades submucosa (pT1)
Tumor invades muscularis propria (pT2)
Tumor invades through the muscularis propria into the subserosal adipose
tissue or the nonperitonealized pericolic or perirectal soft tissues (pT3)
Tumor penetrates to the surface of the visceral peritoneum (serosa)
(pT4a)
Tumor directly invades other organs or structures
(specify:) (pT4b)
Tumor penetrates to the surface of the visceral peritoneum (serosa) and
directly invades other organs or structures
(specify: ) (pT4b)

Margins of resection
Proximal/distal margin
Cannot be assessed
Invasive carcinoma present
Invasive carcinoma absent
Distance of invasive carcinoma from closest margin:
mm
Circumferential (radial) margin
Not applicable
Cannot be assessed
Invasive carcinoma present
Invasive carcinoma absent
Distance of invasive carcinoma from non-peritonealised margin:
mm

Regional lymph nodes
Number examined:
Number involved:

Tumor deposits
Not identified
Present (number: )

Response to neoadjuvant therapy
Not applicable (no prior treatment)
Complete regression
Minimal residual tumor
No marked regression

Extramural venous invasion
Not identified
Present

Pathologic staging (pTNM)
TNM descriptors
(required only if applicable)
m (multiple primary tumors)
r (recurrent)
y (posttreatment)

Primary tumor (pT)
pTX: Cannot be assessed
pT0: No evidence of primary tumor
pTis: Carcinoma in situ, intraepithelial or invasion of lamina propria
pT1: Tumor invades submucosa
pT2: Tumor invades muscularis propria
pT3: Tumor invades through the muscularis propria into pericolorectal
tissues
pT4a: Tumor penetrates the visceral peritoneum
pT4b: Tumor directly invades other organs or structures

Regional lymph nodes (pN)
pNX: Cannot be assessed
pN0: No regional lymph node metastasis
pN1a: Metastasis in 1 regional lymph node
pN1b: Metastasis in 2 to 3 regional lymph nodes
pN1c: Tumor deposit(s) in the subserosa, or nonperitonealized pericolic
or perirectal tissues without regional lymph node metastasis
pN2a: Metastasis in 4 to 6 regional lymph nodes
pN2b: Metastasis in 7 or more regional lymph nodes

Distant metastasis (pM)
Not applicable
pM1: Distant metastasis
Specify site(s):
pM1a: Metastasis to single organ or site (e.g., liver, lung, ovary,
nonregional lymph node)
pM1b: Metastasis to more than one organ/site or to the peritoneum

Additional pathologic findings
None identified
Diverticular disease, ulcerative colitis, Crohn’s disease, familial
adenomatous polyposis, other forms of polyposis, synchronous
carcinoma(s) (complete a separate form for each cancer), etc.
Specify:
Polyps present (specify type and number):

Comments

Reference:
Recommendations for the Reporting of Surgically Resected Specimens of Colorectal Carcinoma
Human Pathology, April 2007 Volume 38, Issue 4, Pages 537–545
55 y.o. Female
Dx 9/26/17 RC Stage 3
Completed 33 rad. tx, xeolda 12/8/17
MRI and PET 1/18 sign. regression
Surgery 1/31/18 Ileostomy, clean margins, no lymph node involved
Port 3/1/2018
Oxaliplatin and Xeloda start 3/22/18


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