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Confused about Pathology report

JennyDra
Posts: 24
Joined: Jan 2015

Hello everyone.....hope you are all well.

Finally got a written version of my husband's pathology reports but I am having a hard time deciphering them.

From what I can make out it says

CK7 - positive ( I definitely have no idea that is)

Cd10 - negative (no idea about that either)

PAX 2 - negative

The actual tumor was 3.5 cm in the end (smaller than the initial scans had shown)

and then it says  T1 NX MX which is confusing because when I looked it up is said that it was not able to be assesed (NX & MX that is)

I mean why was it not able to be assessed?? Anyone have any insight??

Footstomper's picture
Footstomper
Posts: 1238
Joined: Dec 2014

Utter gibberish to me I'm afraid. I'm sure someone more knowledgable will translate it for you. Just wanted you to know I tried

NewDay's picture
NewDay
Posts: 273
Joined: May 2012

Jenny,

This is excellent news!  The things you mention such as CK7 and CD10 refer to stains used on the slides to identify the type of cancer.

The T1 says the tumor was stage 1 which is excellent.  There is very small chance of  it recurring.

The NX says that there was no lymph node tissue provided which is why it was not assessed.  The surgeon did not remove any lymph nodes.  This is not unusual.  Often the surgeon does not remove any unless some look suspicious.

The MX says that there was nothing in the tissue provided that indicates metastatic disease.

I am surprised that there is no mention of the histology like "clear cell" or "chromophobe" of "papillary".

You could not have gotten a better report (other than no cancer of course).

Time to celebarate,

Kathy

JoanneNH
Posts: 115
Joined: Sep 2013

Sounds like it is clear cell tubulopapillary renal cell.   

 

http://surgpathcriteria.stanford.edu/kidney/renal-clear-cell-carcinoma/differential-diagnosis.html

sblairc's picture
sblairc
Posts: 586
Joined: Feb 2014

MX means that they can't assess presence of metastatic disease by pathology report. I"m not sure why exactly makes the difference between MX and M0 (cannot be assessed versus none present)

 

I'd love to know the answer to this as well. For me, I have always assumed for my husband it was "MX" because his stage was so high they didn't want to come out and say M0. But yours is Stage 1 so that throws my theory out the window. 

 

If anyone knows the difference for how they determing M0 and MX please share. 

jason.2835
Posts: 337
Joined: Nov 2014

Sounds a lot like my report, however I was under the impression that if the tumor was under 4 cm it's actually T1a and over 4 cm it's T1b.  Not sure if that is on the report.  Also, another important indicator is Fuhrman grade, which ranges from 1, meaning close to normal tissue, to 4, which look abnormal under low magnification... The lower the grade the better.  Mine was Grade 2.  

JennyDra
Posts: 24
Joined: Jan 2015

I have spent hours trying to research these things on the internet but I don't understand some of the more technical terms on some sites.

His surgon said that his outlook is very good and I am very happy about that. He said next set of scans in six months.

But I think we should see an oncologist just so he can explain what all these results mean from his point of view..

I am happy to be  getting back to normal life....even though i think it's not exactly how it was before. There are always thoughts lurking in my mind...but all in all it's nice to be moving forward. I am praying this was  just one of lifes bumps in the road. I am also praying for all of you ...having this site has made such a difference.  Hope  you are all well. You are in    my thoughts. Thanks again.

dhs1963's picture
dhs1963
Posts: 510
Joined: May 2012

You can, but most oncologists that specialize in RCC will not see patients with T1a low grade, stage 1 tumors.  They just do not have the time.  That is too bad, because these people can really explain why you don't have to worry. 

 

Jojo61's picture
Jojo61
Posts: 1310
Joined: Oct 2013

Well it looked like Greek to me, too. But judging from what other opinnions are, it is good news!

Hurray for good news!!! Celebrate!

Hugs

Jojo

Ree_Maryland's picture
Ree_Maryland
Posts: 158
Joined: May 2014

HI, I had a right neph and it was graded 1b was is the diffence betweeen a an b? thanks hope all is well for you peoples on the journey to good health,

icemantoo's picture
icemantoo
Posts: 3243
Joined: Jan 2010

But what do I know. I am an attorney, not a doctor. At 3.5cm you are going to be around for the long haul.

 

Icemantoo

b1
Posts: 17
Joined: Apr 2014

You may hear your doctor talk about T1a or T1b. T1a means you have a tumour that is less than 4cm across. T1b means the kidney tumour is between 4 and 7cm across.

Ree_Maryland's picture
Ree_Maryland
Posts: 158
Joined: May 2014

Thanks to the folks on here who got ti through my thick head what the A an B means on a scale of RCC , I had a tumor grade1b ,furmor 1

b1
Posts: 17
Joined: Apr 2014

Hi im not a dr either, but from what ive read, t1 means stage 1 under 7 cm and confined to the kidney.

Nx means Nodes unable to be assessed, this is because they wouldnt have removed any nodes to assess, they are only reporting on the bit they removed.

MX is signs of metastasis and once again they would only be looking at the bit they removed. In order to see if it has spread they will do scans and probably blood tests to assess this.

The good news in a sense is that they appear to have caught it early, therefor your chances of it returning are significantly less. Doesnt mean it cant return, thats why you should have a yearly check initially and of course if you start feeling unwell get things checked out. 

 

sblairc's picture
sblairc
Posts: 586
Joined: Feb 2014

This is driving me nuts, I can't seem to find this on the internet. Does anyone know when and why they use this distinction? (i.e., M0 versus MX)

b1
Posts: 17
Joined: Apr 2014

The M category tells whether there are distant metastases (spread of cancer to other parts of body).

 

MX means metastasis can’t be evaluated.

M0 means that no distant cancer spread was found.

M1 means that the cancer has spread to distant organs or tissues (distant metastases were found). 

 

Reading this, if it is mx as opposed to m0 i can only assume the pathologist did not have a scan or report in front of them that tells them whether it has spread. Apart from obviously having extra parts cut out of you, i dont think they can tell if its spread from just looking at the kidney bit they cut out, unless for example parts of other organs are also in front of them. I could of couse be wrong and maybe they can tell, but i dont think so. 

 

 

sblairc's picture
sblairc
Posts: 586
Joined: Feb 2014

And they are probably covering their****** with "MX" versus "MO" so they don't get sued if the cancer comes back which as we know it can and does!

Jmat23's picture
Jmat23
Posts: 23
Joined: Mar 2014

Yes I believe they use MX when they cannot determine metastasis to distant sites microscopically. You'd think this would be in the majority of cases so I'm not sure when M0 would be used.

This is a low stage tumour so perhaps they don't look at these things but the following have been put forward as independant prognostic factors or adverse characteristics (ie can inpact on disease free survival (DFS) or cancer specific survival. For this reason some pathology reports will include this information. I believe these may be related to clear cell type and it sounds like her husbands may be a different type.

* Lymphovasular invasion 

* Invasion of the intrarenal veins

* Tumour necrosis

* Sarcomatoid change

* Renal sinus involvement

 

JennyDra
Posts: 24
Joined: Jan 2015

As far as I have read It says that it is chromophobe.  It also says that the fatty tissue inside the kidney was unaffected.  I am just a bit worried of possible reoccurrence. We will eventually go too the oncologist but I have been really sick with a cold and the weather hasn't been great either. Thanks for the info.

gingersnaps
Posts: 67
Joined: Jul 2013

Did they give you a grade? Some chromophobe are not graded. My son's was grade 3.

sblairc's picture
sblairc
Posts: 586
Joined: Feb 2014

Just as an FYI. I've heard (think I read here) that with Chromophobe a "Grade" is really not a clinical indicator of aggressiveness. Not getting a "Grade" would be logical since it may not be significant FOR CHROMOPHOBE RCC. Other RCC's, it's important. If anyone has anything to add or to this comment, please do so. 

gingersnaps
Posts: 67
Joined: Jul 2013

I know but some places do still grade chromophobe using the furman system. We went to Cleveland clinic and they still used the old grading.

Jmat23's picture
Jmat23
Posts: 23
Joined: Mar 2014

You're welcome Jenny. Chromophobe rcc is rarer than clear cell rcc (5% of cases) and as I have clear cell most of the info I have is based on that type. Some studies say chromophobe has a better prognosis than clear cell and others say it is broadly similar. The smaller sample size due to the relative rarity of chromophobe rcc may lead to the confusion bearing in mind population stats don't really apply to individuals. I'm assuming for rarer types the population statiatics Are even less meaningful. I obviously can't say with any certainty but at grade 2 and a relatively small size, I'd say the prognosis would be very good. The fact they are offering a partial nephrectomy as an option says to me the risk of local recurrance is minimal which to me infers a good prognosis. The oncologist is the expert and I'm sure they will provide all the info you need.

JennyDra
Posts: 24
Joined: Jan 2015

Yes..the pathology report says grade 2 on the fuhrman grading system. I have read that grade one is very rare. any views on grade 2???

gingersnaps
Posts: 67
Joined: Jul 2013

From everything I can read grade is of not significant in chromophobe. There is a different grading system. I was just interested in how many still use Fuhrman. I've read most are a grade 3 on Fuhrman scale.

sblairc's picture
sblairc
Posts: 586
Joined: Feb 2014

I'm wondering if grade is not signficant, how they determine aggressiveness of the tumor in chromophobe. Does anyone know? 

Also, regarding chromophobe being "indolent" or "less aggressive" than clear cell RCC: My husbands oncologist told him that was an outdated theory and that it just tends to be found early in it's clinical stage because they tend to be larger tumors than clear cell. But then I've heard an expert in RCC say different at a conference, so it would seem there is some differing of opinion. 

Jmat23's picture
Jmat23
Posts: 23
Joined: Mar 2014

There is a 3 tier Chromophobe Grading system which I believe they use as opposed to the Furhman grading system. It seems Chromophobe grade 1&2 have similar outcomes with grade 3 being more aggresive as it can relate to Sarcomatoid change in the tumour and hence a greater propensity to spread. Take this with a grain of salt as I could be wrong! I'm not sure what other prognostic factors that might apply to chromophobe rcc - the only one I am aware of is tumour necrosis.

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