• Michael Misialek, MD

Understanding Your Pathology Report


In recognition of National Prostate Cancer Awareness Month, it is appropriate to understand the pathology report. All treatment begins with a diagnosis. It is pathology that provides this first step. If you have been recently diagnosed with cancer, or another disease, it is important to get a copy of your pathology report. In order to be an empowered patient, you need to understand every item in the report.

There are several key elements that should be in every pathology report.

  • Diagnosis – This is the final pathologic diagnosis.

  • Gross description – The macroscopic features of the specimen, i.e. dimensions, color, consistency, etc. are described.

  • Microscopic description – The appearance of the specimen as seen under the microscope is contained here.

  • Synoptic report – Often will be part of the report for a cancer diagnosis when an organ is removed during surgery. Important features of the tumor impacting prognosis and treatment will be listed.

  • Comment – Sometimes in controversial or difficult diagnoses there will be a comment explaining the findings, often with suggestions for follow up testing.

A great resource can be found with this video.

What should you look for if you have been diagnosed with prostate cancer?

For prostate cancer the key findings to look for include the following, likely in the diagnosis section:

  • Histologic type

  • Number of positive cores

  • Location of positive cores

  • Tumor quantitation

  • Gleason grades and score

  • Extraprostatic extension

  • Perineural invasion

  • Other atypical acinar foci suspicious for carcinoma

The Gleason score and tumor extent measurements are the most important pathologic features.

Make sure sampling of the entire prostate – base, mid, apex, lateral, transition zones – both right and left sides, is present. Each of these items is important in determining the best treatment for your specific cancer. No two cancers are alike. This information will allow for a personalized treatment plan designed for your type of cancer.

Make sure the pathologists are board certified, have experience and the lab is accredited by a recognized agency, i.e. the College of American Pathologists.

#prostate #prostatecancer #pathology #pathologyreport

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