I received my results in the mail

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DarknessEmbraced
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Location: New Brunswick, Canada

I received my results in the mail

Postby DarknessEmbraced » Wed Aug 25, 2021 10:19 am

Descending colon biopsy : consists of focally distorted colorectal mucosa with ulceration. Fibrosis, hypertrophy of muscularis mucosa is present. No granulomas are identified. Negative for dysplasia.
I know that negative for dysplasia means it doesn't look like cancer. I don't understand the other parts of that description though.
At the end it says the findings for the descending colon are not specific with differentials including ischemic changes, IBD, infection, etc.. . To me it means the pathologist can't say for certain what it is? Yet ulceration isn't normal and the other things don't sound normal either.
The CT scan with just the contrast I drank said that there was bowel wall thickening at the level of the splenic flexure with mild adjacent hazy stranding. Not really clear because I couldn't have the iv contrast. The appearance is non specific and could indicate underlying ischemic colitis, inflammatory bowel disease or non specific infectious colitis.



Can anyone translate this? I don't talk to my GI until October 8th when I have my telephone appointment. I have a telephone appointment on September 15th with my family doctor but I kind of doubt she would understand it as much as my GI would.
Diagnosed 10/28/14, age 36
Colon Resection 11/20/14, LAR (no illeo)
Stage 2a colon cancer, T3NOMO
Lymph-vascular invasion undetermined
0/22 lymph nodes
No chemo, no radiation
Clear Colonoscopy 04/29/15
NED 10/20/15
Ischemic Colitis 01/21/16
NED 11/10/16
CT Scan moved up due to high CEA 08/21/17
NED 09/25/17
NED 12/21/18
Clear colonoscopy 09/23/19
Clear 5 year scans 11/21/19- Considered cured! :)

catstaff
Posts: 127
Joined: Wed Mar 03, 2021 11:37 am

Re: I received my results in the mail

Postby catstaff » Wed Aug 25, 2021 12:37 pm

I am not a pathologist, but as I understand this, it means that the lining of your colon is ulcerated, thickened, and scarred, but not precancerous. But they cannot tell from these findings alone what may be causing it since multiple diseases could result in this appearance.
D/H Dx 10/2019 RC age 61
Clinical T4bN2M1a (common iliac and para-aortic lymph nodes)
MSS KRAS G12D
CRT 11/19-1/20 FOLFOX 3/20-7/20
Pelvic exenteration w/LAR 8/20
ypT4bN0Mx G3 0/14 nodes LVI not seen PNI-
CEA 10/19:20, 1/20-11/20:1.6, 4.3, 3.4, 2.7, 2/21:9.0 3/21:18,40 4/21:28,19, 5/21:13.3,8.6
PET 3/21 recurrence in distal nodes, L5 vertebra, pelvis
FOLFIRI+bev 3/21-

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O Stoma Mia
Posts: 1647
Joined: Sat Jun 22, 2013 6:29 am

Re: I received my results in the mail

Postby O Stoma Mia » Wed Aug 25, 2021 12:46 pm

DarknessEmbraced wrote:
Descending colon biopsy :
    Consists of focally distorted colorectal mucosa with ulceration. Fibrosis, hypertrophy of muscularis mucosa is present. No granulomas are identified. Negative for dysplasia.

I know that negative for dysplasia means it doesn't look like cancer. I don't understand the other parts of that description though.
At the end it says:

    The findings for the descending colon are not specific with differentials including ischemic changes, IBD, infection, etc.. .

To me it means the pathologist can't say for certain what it is? Yet ulceration isn't normal and the other things don't sound normal either.
The CT scan with just the contrast I drank said that

CT scan
    There was bowel wall thickening at the level of the splenic flexure with mild adjacent hazy stranding.

Not really clear because I couldn't have the iv contrast.

    The appearance is non specific and could indicate underlying ischemic colitis, inflammatory bowel disease or non specific infectious colitis.

Colonoscopy Report
    Redundant colon

Can anyone translate this? I don't talk to my GI until October 8th when I have my telephone appointment. I have a telephone appointment on September 15th with my family doctor but I kind of doubt she would understand it as much as my GI would.


Bowel wall thickening at CT: simplifying the diagnosis
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3999365/

Disproportionate Fat Stranding: A Helpful CT Sign in Patients with Acute Abdominal Pain
https://pubs.rsna.org/doi/full/10.1148/rg.243035084

Iatrogenic Injury to the Inferior Mesenteric Artery
https://s3.amazonaws.com/classconnection/849/flashcards/1794849/png/ima-14C919C98D71DD00863.png

Iatrogenic Disorders
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4923397/

Intestinal Fibrosis
https://www.sciencedirect.com/science/article/pii/S2468509718300010

Intestinal Dysmotility
https://coloncancersupport.colonclub.com/viewtopic.php?f=1&t=55120&p=436918&hilit=dysmotility#p436918
https://agmdhope.org/list-of-motility-disorders/
http://www.mygutsy.com/remedies-for-intestinal-dysmotility/

What is Inflammatory Bowel Disease (IBD)?
https://www.cdc.gov/ibd/what-is-ibd.htm

Please note that CT scans are not particularly useful in diagnosing ischemic colitis. This is because the scans cannot see the detail of the capillaries and small blood vessels to determine whether or not they are constricted and they cannot tell the color of the mucosa. It would be the colonoscopy report that would contain this kind of information, in particular the photos taken at different points in the colon showing the color and texture of the mucosa in different locations. You would have to ask your gastroenterologist about this.

If you have some time between now and October 8th you could study the document below so that you can be more fully prepared for the doctor's phone call when it eventually arrives.

ACG Clinical Guideline: Epidemiology, Risk Factors, Patterns of Presentation, Diagnosis, and Management of Colon Ischemia (CI)
https://www.spg.pt/wp-content/uploads/2015/11/2015-ACG-colon-ischemia.pdf

This is a good article because it explains
  • the different types of ischemic colitis,
  • the different situations that can give rise to an ischemic colitis crisis,
  • the available treatments to alleviate symptoms or to cure ischemic colitis.
Also, it is an evidence-based article with 190 scientific references to support its various recommendations/conclusions.

If you follow the text closely and look up the relevant footnotes you will see that your particular variant of ischemic colitis -- and its diagnosis and treatment scenario -- are indeed covered there. But you have to read the fine print and wade through all of the technical jargon.
Last edited by O Stoma Mia on Sun Aug 29, 2021 12:10 am, edited 5 times in total.

DarknessEmbraced
Posts: 3629
Joined: Sat Nov 01, 2014 4:54 pm
Facebook Username: Riann Fletcher
Location: New Brunswick, Canada

Re: I received my results in the mail

Postby DarknessEmbraced » Wed Aug 25, 2021 1:19 pm

Thank you catstaff and O Stoma Mia! I will check out those articles. I'm also hearing that ulcerative colitis could be a possibility from these results. I had the colonoscopy and CT scan while hospitalized in July. The doctor who was following me while I was hospitalized, told me my GI said that it looked like ischemic colitis. It said I have this on the colonoscopy report: https://www.healthline.com/health/redundant-colon
Diagnosed 10/28/14, age 36
Colon Resection 11/20/14, LAR (no illeo)
Stage 2a colon cancer, T3NOMO
Lymph-vascular invasion undetermined
0/22 lymph nodes
No chemo, no radiation
Clear Colonoscopy 04/29/15
NED 10/20/15
Ischemic Colitis 01/21/16
NED 11/10/16
CT Scan moved up due to high CEA 08/21/17
NED 09/25/17
NED 12/21/18
Clear colonoscopy 09/23/19
Clear 5 year scans 11/21/19- Considered cured! :)

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O Stoma Mia
Posts: 1647
Joined: Sat Jun 22, 2013 6:29 am

Re: I received my results in the mail

Postby O Stoma Mia » Wed Sep 08, 2021 9:03 pm

There is still time before your next doctor/patient telephone appointments for you to get all of your questions lined up and prioritized.

All projects -- whether they be in journalism, law, science, engineering, etc. -- need to make effective use of the six main question words: Who? Where? What? Why? When? How?

This includes medical projects involving diagnosis, treatment, surveillance and follow-up.

In the case of medical projects, both the doctors and patients have the obligation to cover all six of these areas in order to insure that everything is covered and that nothing is allowed to "fall between the cracks".

The 5 Ws (and 1 H) that should be asked of every project!

https://www.workfront.com/blog/project-management-101-the-5-ws-and-1-h-that-should-be-asked-of-every-project

Now that you have the results from some of your recent procedures and exams, you can start preparing the full range of questions necessary for clarifying your diagnosis and your treatment options.

You need to be active, not passive in this regard. You need to be prepared for whatever may develop in your upcoming telephone interviews.

DarknessEmbraced
Posts: 3629
Joined: Sat Nov 01, 2014 4:54 pm
Facebook Username: Riann Fletcher
Location: New Brunswick, Canada

Re: I received my results in the mail

Postby DarknessEmbraced » Sat Sep 11, 2021 10:03 am

Thank you O Stoma Mia! I would look over the links. I have been writing down questions and symptoms. Thursday night I had hours of severe diarrhea and severe cramping. No bleeding. It was severe diarrhea like when I went to the ER and was hospitalized in July. I had never had blood clots like I passed in July.
Diagnosed 10/28/14, age 36
Colon Resection 11/20/14, LAR (no illeo)
Stage 2a colon cancer, T3NOMO
Lymph-vascular invasion undetermined
0/22 lymph nodes
No chemo, no radiation
Clear Colonoscopy 04/29/15
NED 10/20/15
Ischemic Colitis 01/21/16
NED 11/10/16
CT Scan moved up due to high CEA 08/21/17
NED 09/25/17
NED 12/21/18
Clear colonoscopy 09/23/19
Clear 5 year scans 11/21/19- Considered cured! :)


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