Evaluation of suspected malignancies: Difference between revisions
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If a '''neoplasm has been ruled out''' for what clinically appeared like a tumor, seek a diagnosis that can be consistent with such a clinical finding. For example, for a breast biopsy of what appeared to look like a mass, and there is no neoplasia, look mainly for dense fibrosis, so that you can report that thereby explain the finding, rather than merely write "benign breast tissue". | If a '''neoplasm has been ruled out''' for what clinically appeared like a tumor, seek a diagnosis that can be consistent with such a clinical finding. For example, for a breast biopsy of what appeared to look like a mass, and there is no neoplasia, look mainly for dense fibrosis, so that you can report that thereby explain the finding, rather than merely write "benign breast tissue". | ||
==Additional levels or slices== | |||
Additional material is indicated in the following situations: | |||
*Re-excision does not identify tumor cells in a clearly non-radical primary excision or biopsy. | |||
*The most aggressive pattern is seen in the last available section, in which case more sections are indicated (from the same paraffin block if additional tissue is not available). | |||
Depending on availability and greatest suspicion, additional material is either acquired by taking addition step sections of remaining tissue in a paraffin block, or taking additional slices from the original specimen. | |||
==Staging== | ==Staging== | ||
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[[File:Histopathology of pancreatic adenocarcinoma with treatment effect.jpg|thumb|Also note "treatment effect", seen as fibroelastotic tissue, here with scattered remaining tumor cells.]] | [[File:Histopathology of pancreatic adenocarcinoma with treatment effect.jpg|thumb|Also note "treatment effect", seen as fibroelastotic tissue, here with scattered remaining tumor cells.]] | ||
Beyond determining overall malignancy diagnosis (such as adenocarcinoma), probable origin and staging, classification of tumors into a specific histopathologic type or grade is generally of relatively less value. In cases of clearly non-malignant tumors where it is difficult to determine the specific histopathologic type or grade, it is generally acceptable to conclude the evaluation and report it as such, unless the clinician specifically requests otherwise. For potentially malignant or high-risk tumors, typing and grading often still affects the management. | Beyond determining overall malignancy diagnosis (such as adenocarcinoma), probable origin and staging, classification of tumors into a specific histopathologic type or grade is generally of relatively less value. In cases of clearly non-malignant tumors where it is difficult to determine the specific histopathologic type or grade, it is generally acceptable to conclude the evaluation and report it as such, unless the clinician specifically requests otherwise. For potentially malignant or high-risk tumors, typing and grading often still affects the management. | ||
==Reporting== | ==Reporting== | ||