Sep 09, 2011 - 12:14 pm
A while ago I asked a question about the meaning of these two items on the pathology report. No one responded, which makes me think that no one was sure what they meant or maybe they didn't want to alarm me. This is my layman's understanding of these two items now. On my pathology report, both of these were indicated as "present" and I'm guessing that is why my Stage T1a is a Furhman Grade 2 instead of a Grade 1. My urologist told me that if he had done a partial nephrectomy he would be more concerned with the lymph vascular invasion report because that would mean we wouldn't know whether or not it was still present in the remaining portion of the kidney and that if it was it could eventually spread to other parts of the body. Taking the whole kidney showed it was only in that one area of the kidney. Of course, there's a possibility that it could have already spread to the other kidney or to other parts of the body, as we all know. Tumor necrosis, as I read it below, can be good news or bad news -- indicating faster growing cancer but limited to a small area.
The following was obtained from BreastCancer.org. It is specific to breast cancer but the info appears to be valid for kidney cancer as well.
Answer —Ann Ainsworth, M.D.: Lymphatic or vascular invasion means that the tumor cells have gotten into the fluid-carrying channels within the breast. Tumors with this kind of invasion are at increased risk for spread beyond the main cancer within the breast, to the lymph nodes, and possibly to other areas of the body.
Necrosis in the tumor means that the cancer cells in that area are dead. The pathologic finding of necrosis suggests a fast-growing cancer. This often happens because the tumor runs out of blood supply in the central portion. Without a blood supply, the tumor cells cannot live. When a tumor is necrotic, it may be difficult or impossible to diagnose on a small biopsy, and an additional sample might need to be taken. Tumor necrosis is often focal (limited to a small area) in the region. There are usually living cancer cells nearby that can be diagnosed as cancer using a microscope.
This information has been helpful to me so I share it here in the hopes that it might be helpful to others in understanding their pathology report. I would appreciate feedback if anybody with a better understanding has anything to add or can clarify anything.