wife- looking for support and information

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Comments

  • Old Salt
    Old Salt Member Posts: 1,530 Member
    edited January 5 #22

    I agree that the path report is weird; in fact, it's incomplete. No info on samples A-H. Was a page 'dropped' somewhere?

    We often suggest sending the samples to Johns Hopkins pathology for a second evaluation. Considering the 'weirdness' of the pathology report, this might be appropriate.

    Get a Second Opinion | Johns Hopkins Pathology (jhu.edu)

  • teammiller425
    teammiller425 Member Posts: 21 Member

    Wow- I never would have considered that- Thank you- I'll see if I can re upload as well. This looks better-

    DIAGNOSIS

    A. Prostate, region of interest #1; biopsy: - Benign prostatic tissue.

    - Negative for malignancy.

    B. Prostate, right lateral base; biopsy: - Benign prostatic tissue.

    - Negative for malignancy.

    C. Prostate, left lateral base; biopsy: - Benign prostatic tissue.

    - Negative for malignancy.

    D. Prostate, right lateral mid; biopsy: - Benign prostatic tissue.

    - Negative for malignancy.

    E. Prostate, left lateral mid; biopsy: - Benign prostatic tissue.

    - Negative for malignancy.

    F. Prostate, right lateral apex; biopsy: - Benign prostatic tissue.

    - Negative for malignancy.

    G. Prostate, left lateral apex; biopsy: - Benign prostatic tissue.

    - Negative for malignancy.

    H. Prostate, right base; biopsy:

    Patient Name: MILLER,DOB: 5/29/1969

    MRN: AEPM-0003324559; 00-01-24-63-46

    Asheville Surgery Center FIN# 256273733317

    Page 1 of 4

    Report Request ID 653484945

    Patient Name MILLER, Birth Date 5/29/1969

    11/20/2023 09:59 EST 11/20/2023 09:59 EST

    DIAGNOSIS

    - Benign prostatic tissue. - Negative for malignancy.

    MRN AEPM-0003324559; 00-01-24-63-46

    I. Prostate, left base; biopsy:

    - Acinar adenocarcinoma, Gleason score 4+4=8 (grade group 4). - Tumor involves 5 of 8 mm, 63% of the tissue, 1 of 1 core.

    J. Prostate, right mid; biopsy: - Benign prostatic tissue.

    - Negative for malignancy.

    K. Prostate, left mid; biopsy: - Benign prostatic tissue.

    - Negative for malignancy.

    L. Prostate, right apex; biopsy: - Benign prostatic tissue.

    - Negative for malignancy.

    M. Prostate, left apex; biopsy:

    - Acinar adenocarcinoma, Gleason score 4+4=8 (grade group 4). - Tumor involves 5 of 8 mm, 63% of the tissue, 1 of 1 core.

    Kraynie MD[S], Alyssa M, MD (Electronically signed) 11/24/2023 15:23

    CLINICAL INFORMATION

    elevated psa

    SPECIMEN SOURCE

    1. A Region of interest #1 prostate biopsy
    2. B Right lateral base prostate biopsy
    3. C Left lateral base prostate biopsy
    4. D Right lateral mid prostate biopsy
    5. E Left lateral mid prostate biopsy
    6. F Right lateral apex prostate biopsy
    7. G Left lateral apex prostate biopsy

    FIN# 256273733317

    Asheville Surgery Center

    Pathology

    11/20/2023 11:56 EST 11/20/2023 11:56 EST

    Page 2 of 4

    Report Request ID 653484945

    Patient Name MILLER, Birth Date 5/29/1969

    11/20/2023 09:59 EST 11/20/2023 09:59 EST

    SPECIMEN SOURCE

    1. H Right base prostate biopsy
    2. I Left base prostate biopsy
    3. J Right mid prostate biopsy
    4. K Left mid prostate biopsy
    5. L Right apex prostate biopsy
    6. M Left apex prostate biopsy

    GROSS DESCRIPTION

    MRN AEPM-0003324559; 00-01-24-63-46

    Pathology

    There are thirteen parts received in formalin, each labeled with the patient’s name and hospital number.

    A. Part A is labeled "ROI #1" and consists of a 1.4 x 0.4 x 0.2 cm aggregate of multiple cores of tan soft tissue. The tissue is submitted in toto in one cassette.

    B. Part B is labeled "right lateral base" and consists of a 1.3 cm aggregate of two cores of tan soft tissue. The tissue is submitted in toto in one cassette.

    C. Part C is labeled "left lateral base" and consists of a 1.1 cm core of tan soft tissue. The tissue is submitted in toto in one cassette.

    D. Part D is labeled "right lateral mid" and consists of a 1.1 cm core of tan soft tissue. The tissue is submitted in toto in one cassette.

    E. Part E is labeled "left lateral mid" and consists of a 1.1 cm core of tan soft tissue. The tissue is submitted in toto in one cassette.

    F. Part F is labeled "right lateral apex" and consists of a 1.5 cm core of tan soft tissue. The tissue is submitted in toto in one cassette.

    G. Part G is labeled "left lateral apex" and consists of a 1.6 cm core of tan soft tissue. The tissue is submitted in toto in one cassette.

    H. Part H is labeled "right base" and consists of a 1.3 cm core of tan soft tissue. The tissue is submitted in toto in one cassette.

    I. Part I is labeled "left base" and consists of a 1.0 cm core of tan soft tissue. The tissue is submitted in toto in one cassette.

    FIN# 256273733317 Asheville Surgery Center

    11/20/2023 11:56 EST 11/20/2023 11:56 EST

    Page 3 of 4

    Report Request ID 653484945

    Patient Name Birth Date 5/29/1969

    11/20/2023 09:59 EST 11/20/2023 09:59 EST

    GROSS DESCRIPTION

    MRN AEPM-0003324559; 00-01-24-63-46

    Pathology

    J. Part J is labeled "right mid" and consists of a 1.5 cm core of tan soft tissue. The tissue is submitted in toto in one cassette.

    K. Part K is labeled "left mid" and consists of a 0.9 cm core of tan soft tissue. The tissue is submitted in toto in one cassette.

    L. Part L is labeled "right apex" and consists of a 1.6 cm aggregate length of two cores of tan soft tissue. The tissue is submitted in toto in one cassette.

    M. art M is labeled "left apex" and consists of a 1.0 cm core of tan soft tissue. The tissue is submitted in toto in one cassette.

    kb/fr

    MICROSCOPIC DESCRIPTION

    Microscopic examination has been performed. CPT: 88305 x 13

    ____________________________________________________________
    

    Technical Services performed at Laboratory Management Services, LLC (North Carolina Division, HCA Healthcare).

    Professional services performed at Mission Hospital, 509 Biltmore Avenue, Asheville, NC 28801

    FIN# 256273733317 Asheville Surgery Center

    11/20/2023 11:56 EST 11/20/2023 11:56 EST

    Page 4 of 4 

  • teammiller425
    teammiller425 Member Posts: 21 Member

    I pasted the biopsy report above.... Thoughts?

  • teammiller425
    teammiller425 Member Posts: 21 Member

    DIAGNOSIS

    A. Prostate, region of interest #1; biopsy: - Benign prostatic tissue.

    - Negative for malignancy.

    B. Prostate, right lateral base; biopsy: - Benign prostatic tissue.

    - Negative for malignancy.

    C. Prostate, left lateral base; biopsy: - Benign prostatic tissue.

    - Negative for malignancy.

    D. Prostate, right lateral mid; biopsy: - Benign prostatic tissue.

    - Negative for malignancy.

    E. Prostate, left lateral mid; biopsy: - Benign prostatic tissue.

    - Negative for malignancy.

    F. Prostate, right lateral apex; biopsy: - Benign prostatic tissue.

    - Negative for malignancy.

    G. Prostate, left lateral apex; biopsy: - Benign prostatic tissue.

    - Negative for malignancy.

    H. Prostate, right base; biopsy:

    Patient Name: MILLER, DOB: 5/29/1969

    MRN: AEPM-0003324559; 00-01-24-63-46

    Asheville Surgery Center FIN# 256273733317

    Page 1 of 4

    Report Request ID 653484945

    Patient Name MILLER, Birth Date 5/29/1969

    11/20/2023 09:59 EST 11/20/2023 09:59 EST

    DIAGNOSIS

    - Benign prostatic tissue. - Negative for malignancy.

    MRN AEPM-0003324559; 00-01-24-63-46

    I. Prostate, left base; biopsy:

    - Acinar adenocarcinoma, Gleason score 4+4=8 (grade group 4). - Tumor involves 5 of 8 mm, 63% of the tissue, 1 of 1 core.

    J. Prostate, right mid; biopsy: - Benign prostatic tissue.

    - Negative for malignancy.

    K. Prostate, left mid; biopsy: - Benign prostatic tissue.

    - Negative for malignancy.

    L. Prostate, right apex; biopsy: - Benign prostatic tissue.

    - Negative for malignancy.

    M. Prostate, left apex; biopsy:

    - Acinar adenocarcinoma, Gleason score 4+4=8 (grade group 4). - Tumor involves 5 of 8 mm, 63% of the tissue, 1 of 1 core.

    Kraynie MD[S], Alyssa M, MD (Electronically signed) 11/24/2023 15:23

    CLINICAL INFORMATION

    elevated psa

    SPECIMEN SOURCE

    1. A Region of interest #1 prostate biopsy
    2. B Right lateral base prostate biopsy
    3. C Left lateral base prostate biopsy
    4. D Right lateral mid prostate biopsy
    5. E Left lateral mid prostate biopsy
    6. F Right lateral apex prostate biopsy
    7. G Left lateral apex prostate biopsy

    FIN# 256273733317

    Asheville Surgery Center

    Pathology

    11/20/2023 11:56 EST 11/20/2023 11:56 EST

    Page 2 of 4

    Report Request ID 653484945

    Patient Name MILLER,Birth Date 5/29/1969

    11/20/2023 09:59 EST 11/20/2023 09:59 EST

    SPECIMEN SOURCE

    1. H Right base prostate biopsy
    2. I Left base prostate biopsy
    3. J Right mid prostate biopsy
    4. K Left mid prostate biopsy
    5. L Right apex prostate biopsy
    6. M Left apex prostate biopsy

    GROSS DESCRIPTION

    MRN AEPM-0003324559; 00-01-24-63-46

    Pathology

    There are thirteen parts received in formalin, each labeled with the patient’s name and hospital number.

    A. Part A is labeled "ROI #1" and consists of a 1.4 x 0.4 x 0.2 cm aggregate of multiple cores of tan soft tissue. The tissue is submitted in toto in one cassette.

    B. Part B is labeled "right lateral base" and consists of a 1.3 cm aggregate of two cores of tan soft tissue. The tissue is submitted in toto in one cassette.

    C. Part C is labeled "left lateral base" and consists of a 1.1 cm core of tan soft tissue. The tissue is submitted in toto in one cassette.

    D. Part D is labeled "right lateral mid" and consists of a 1.1 cm core of tan soft tissue. The tissue is submitted in toto in one cassette.

    E. Part E is labeled "left lateral mid" and consists of a 1.1 cm core of tan soft tissue. The tissue is submitted in toto in one cassette.

    F. Part F is labeled "right lateral apex" and consists of a 1.5 cm core of tan soft tissue. The tissue is submitted in toto in one cassette.

    G. Part G is labeled "left lateral apex" and consists of a 1.6 cm core of tan soft tissue. The tissue is submitted in toto in one cassette.

    H. Part H is labeled "right base" and consists of a 1.3 cm core of tan soft tissue. The tissue is submitted in toto in one cassette.

    I. Part I is labeled "left base" and consists of a 1.0 cm core of tan soft tissue. The tissue is submitted in toto in one cassette.

    FIN# 256273733317 Asheville Surgery Center

    11/20/2023 11:56 EST 11/20/2023 11:56 EST

    Page 3 of 4

    Report Request ID 653484945

    Patient Name MILLER, Birth Date 5/29/1969

    11/20/2023 09:59 EST 11/20/2023 09:59 EST

    GROSS DESCRIPTION

    MRN AEPM-0003324559; 00-01-24-63-46

    Pathology

    J. Part J is labeled "right mid" and consists of a 1.5 cm core of tan soft tissue. The tissue is submitted in toto in one cassette.

    K. Part K is labeled "left mid" and consists of a 0.9 cm core of tan soft tissue. The tissue is submitted in toto in one cassette.

    L. Part L is labeled "right apex" and consists of a 1.6 cm aggregate length of two cores of tan soft tissue. The tissue is submitted in toto in one cassette.

    M. art M is labeled "left apex" and consists of a 1.0 cm core of tan soft tissue. The tissue is submitted in toto in one cassette.

    kb/fr

    MICROSCOPIC DESCRIPTION

    Microscopic examination has been performed. CPT: 88305 x 13

    ____________________________________________________________
    

    Technical Services performed at Laboratory Management Services, LLC (North Carolina Division, HCA Healthcare).

    Professional services performed at Mission Hospital, 509 Biltmore Avenue, Asheville, NC 28801

    FIN# 256273733317 Asheville Surgery Center

    11/20/2023 11:56 EST 11/20/2023 11:56 EST

    Page 4 of 4 

  • teammiller425
    teammiller425 Member Posts: 21 Member
  • VascodaGama
    VascodaGama Member Posts: 3,707 Member
    edited January 6 #27

    Thanks for sharing the report.

    2 positive cores out of 12+1, is not much of cancer.

    The extra core from the "Region of interest #1", which may have been chosen by the urologist (probably because of suspicious of a deformation identified in a scan) is also negative.

    Though the Gleason score of 8 (4+4) classifies it in the "risky" group, because of the only two positive cores, it could lead to think that this is a contained case.

    The core I (left base) is tricky. It stands close to the bladder, an area where the sphincter is located. This is an area prune to damage of the sphincter if radiated.

    The core M (left apex) is taken closer to the colon. In-between are all negative.

    I tend to say now that surgery seems to be a good choice. I also agree with Old Salt's suggestion in getting a second opinion on the slides of the biopsy.

    Of course, if you manage to get approval for a 68Ga-PSMA PET, it would add more information, particularly to far metastases. However, this exam, in the areas closer to the bladder (prostate bed) do not always give detailed images that could identify extraprostatic invasion of the gland's capsule (discussed in my previous post). The isotope excreted via the urine (in the bladder) makes the image blurred.

    Please note that I am not a doctor. I have years of experience in treating and living with the bandit.

    Best wishes

    VGama

  • teammiller425
    teammiller425 Member Posts: 21 Member

    Thank you for your input- Makes me feel a little better - I so appreciate the time and effort in replying to my concerns- I share all of this with my husband too and he really appreciates it!!