"Histologic examination revealed pieces of soft tissue covered by normal and atypical stratified squamous epithelium with overlying material. Atypical cells exhibiting nuclear hyperchromasia, increased mitotic activity and cellular pieomorphism directly invaded the underlying fibrous tissues. Neoplastic cells formed tumor islands and sheets. Focally infiltrating between skeletal muscle bundles. Perineural invasion was noted. Some inflammatory cells were present."

I have a lesion on the bottom of my left of my tongue. No pain.

Can anyone decipher this? My chest xray was clear.

My team at Yale thinks I am ok to wait two weeks for surgery...

The only way to truly interpret this is to have your MO or H&N surgeon explain it to you or you would have to look up every word in a medical encyclopedia, then all of the associated words and still not get it right.

But, for what it's worth, IMO, it sounds like a typical early stage tongue cancer pathology report. The 2 most important terms in a path report are: Differentiation -which means has the cancer remained in one tissue type ("well differentiated") or is in the bone, muscle, lymph and other soft tissue ("poorly differentiated"), in other words it's degree of invasiness? Secondly "Focally infiltrating" is related to differention. Ideally you only want one tissue type involved.

Without knowing the degree of differentiation, it is difficult to interpret your report (and we are not doctors or pathologists anyway). We might sound like it at times, but we are patients and/or caregivers just like you.

Gail,
I cannot deciper it but compare it to mine which was moderately well differentiated. I had invasion of skeletal muscle focally, but not anything about fibrous tissues or perineural invasion. Mine was only 1 mm deep, and less than 1 cm at the widest point. Some of that other stuff is the same, and I apparently had more inflammation than you. The second pathology dept that had a go at it (using slides as I had the lesion removed 5 days after it was found) called it "superficially invasive SCC", meaning it did not penetrate the basement membrane. As you see I had a lymph node involved, so tricky stuff. I made one more switch after that, slightly diff. pathology report (still moderately well diff) and those were the folks I stayed with.
Anne

[quote=Gary]...But, for what it's worth, IMO, it sounds like a typical early stage tongue cancer pathology report. The 2 most important terms in a path report are: Differentiation -which means has the cancer remained in one tissue type ("well differentiated") or is in the bone, muscle, lymph and other soft tissue ("poorly differentiated"), in other words it's degree of invasiness? Secondly "Focally infiltrating" is related to differention. Ideally you only want one tissue type involved.... [/quote]

Somewhat different; pertaining to cancer cell differentiation, I was told a "well differentiated cancer cell" is very similar to a normal cell, but a "poorly differentiated cancer cell" has devolved into a somewhat primitive cellular structure that reproduces frequently and haphazardly in an out of control manner.

I was also told that radiation is considerably more effective on the poorly differentiated cancer cells because they have lost the ability to effective repair the DNA damage it does.

Yes, and chemo is more effective against it as well. BTW, any metastasis can have a different histology/aggressive state than the primary. And if any bits of poorly diff cancer that are left standing after burning & poisoning (rad & chemo) they may become well diff., or at least that is what I picked up from the discussion I had about it.

Anne

Gail,
Actually I think you are asking us: can this wait 2 weeks? Probably none of us are qualified to answer that. I can tell you lots of places would make you wait 2 weeks and say it would not matter.

After my primary was excised, and the lymph node surfaced (almost immediately, it seemed), I went to the nearest we had to a ccc; they are applying for NCI status. I had been there before the lymph node, so I already had an "in". They could not do the surgery on the lymph node and a neck dissection for about 4 weeks, and told me it would not matter. They said all their patients had cancer & could not bump anyone in favor of me--I had not asked for that either! So utilizing that time, I got a second opinion, took more than a week to get my first appointment after I got all my records & applications done, and they got me in before that 4 weeks surgery date, although only 4 days, but it meant that I would see one of my sons that way. So the surgery transpired there only a week after I was first seen. They seemed to think it did matter, but maybe I was lucky. So bottom line was I did not get in much earlier at MD Anderson, but it felt like I did!

So you probably at this point could not get in earlier for the surgery too many places, by the time you jumped through hoops. If you trust your doctors, I would think you would have to go with them.
You did not say if you had a lymph node involved. I would think they would discuss having treatment after surgery, or are they also doing a neck dissection when they remove the primary?

Best of luck and hope this helps!
Anne

Sorry - not asking someone for their diagnosis/interpretation. I have already spoken to my doctor at Yale and my pre-op is scheduled for Friday.

Just letting you know what report this "newbie" got and how I tried to google every single word to try and figure out what was going on while I was waiting.

Thought I would run it by you guys.

Sorry for the confusion and/or waste of your time. I did not mean that and should have clarified myself.

Gail,
No problem! I was just trying to help out. And I am embarrassed I got into it deeper than you meant. I did the same thing with my path & asked the doctors as well. It was all new to me.
Best,
Anne

Sorry, everyone, especially Anne.

Just freaking myself out and wanted some help from those of you who have been through this.

One woman, who had similar biopsy, told me she had a trach, feeding tube, jaw split, and spent almost 2 weeks in hospital, and I was bracing for the worst, hoping for the best, since my doctor told me they caught it early and it would, probably be "routine". Obviously nothing here is routine.

Again, didn't mean to alarm or waste anyone's time. Just wanted someone to help me understand...

Thanks again, Anne. You shouldn't be embarrassed. I am truly thankful to you..

Gail,
no problem - freaking out comes with the disease (I passed out when I got my Dx) and please never think that you are wasting our time.