How to Read a Pathology Report
A pathology report describes the characteristics of a tissue specimen obtained at the time of biopsy. Pathologists have special training in identifying diseases by studying cells and tissues under a microscope. The report includes a gross visual description , a microscopic description, comments and a final diagnosis.
Common terms that may appear on a cancer pathology report include:
· in situ
If surgery is used to remove part or all a tumor, some or all the removed tumor specimen will be examined by the pathologist. If the entire tumor is removed, typically the surgeon will attempt to remove some normal tissue around the tumor, known as the margin for examination. To examine the specimen the tissue must be fixed in formalin, placed in molten paraffin, and cut into very thin slices, called sections, placed onto microscope slides. and stained with dyes to help the pathologist visualize parts of the cell and structures in the tissue under a microscope.
Another pathological technique used by pathologists in concert with the surgeon is a frozen section. They are when an immediate answer about a tissue sample is needed to provide
the surgeon with a rapid diagnosis for an area of abnormal tissue and the extent of the abnormal area while the patient is in the operating room.
On the pathology report the gross description includes the color, weight, size of a tissue sample as seen by the naked eye and any visible abnormalities.
The microscopic description on pathology report includes information about the appearance of the cells after they have been stained and viewed under the microscope. The narrative describes the type and number of cells seen in the tissue sample, the presence or absence of abnormal cells, to define the tumor grade, and whether abnormal cells are found in the margins, the edges of the tissue or in lymph nodes. Lymph nodes are called positive if they have cancer cells and negative if they do not.
This description may also include the results of additional tests that were performed on the tissue including:
· Properties of the cells: number of cells, percentage of live cells, cell size and shape, and the proportion of cells that have a tumor marker
· Investigation of genetic or molecular abnormalities in specimens: karyotyping to detect abnormal chromosomes as well as fluorescence in situ hybridization, to detect specific chromosomal deletions or translocations
The diagnosis section of a pathology report is the pathologist’s summary of all the findings of their visual and microscopic examination of the tissue specimen, in combination with relevant clinical information. It is in this section that the cancer type will be identified, including the tumor grade, lymph node status, margin status, and stage.