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Wed, 04 Apr 2007 18:49:18 +0100

Rosie,

I agree that this pathology report is most confusing. �Maybe in time, it will all make sense.

The original low-grade path in January 2006 states:

[quote]Diagnosis

TUR Bladder tumor:
� � Non-invasive papillary transitional cell carcinoma, Grade II/IV[/quote]

The March 2006 biopsy states:

FINAL DIAGNOSIS:

[quote]Bladder Tumor, Biopsy:
� � Invasive High Grade Urothelial Carcinoma with inverted growth pattern
� � Carcinoma is invasive into lamina propria
� �
Comment

The biopsy of bladder mass from March 20, 2006 shows nests of urothelium proliferation in the lamina propria. �The nests of urothelium in the lamina propria are variable in size, some of them with irregular contour and with focal dosmoplastic response. �There is moderate cytologic atypia. �This case is interpreted as invasive urothelial carcinoma with inverted growth pattern. �Much of the tumor is low grade, but a few areas show more cytologic atypia and more mitoses, and are interpreted as high grade. �Dr. ....has also reviewed this case and agrees with this diagnosis. �This tumor is staged as pT1, pNx, pMx. [/quote]

I am thinking that when the small "p" is in front of the T, it means papilllary?

This whole thing has never made any sense to me from the get-go. �Why wasn't any "atypia" or "mitosis" seen in the very first biopsy specimen in January? �If it progressed that quickly, then why wasn't it back again when I went for 3rd biopsy 6 weeks later?

Thanks for your interest, Rosie. �It's like an Agatha Christie mystery.... ::)

This may be helpful...

[quote]Definition of In situ

In situ: In the normal location. An "in situ" tumor is one that is confined to its site of origin and has not invaded neighboring tissue or gone elsewhere in the body.

For example, squamous cell carcinoma in situ is an early stage of skin cancer. It is a tumor that develops from the squamous cells which are flat, scalelike cells in the outer layer of the skin (the epithelium).

The term "in situ" is borrowed from the Romans. It means "in the natural or normal place" and, in the case of cancer, it is good news. It indicates that the tumor cells are still where they originated. They have neither entered neighboring tissues nor have they metastasized afar.[/quote]

Thanks a bunch,
Rosemary - Rosemary

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Wed, 04 Apr 2007 13:36:02 +0100

Rosemary, I read your post carefully and am still confused as to your pathology reports. Particurlary this part where is states - TNM (T) staging information based on available information: Ta: In situ carcinoma (papillary): -. What was it - In Situ Carcinoma (CIS) or papillary (TCC). CIS/TIS/In Situ Carcinoma - all the same type stated differently is not a papillary or TCC - transitional cell carcinoma. In Situ is a flat red growth where papillary is like flowery growth. Were those pathology reports sent to you from your current urologists office? I remember in another post you stated your current doctor is stating you have/had TA G1 or G2. There is quite a difference in treatment depending on the type - was it In Situ or Papllary? Is it T1 G3 or TA G1, or TA G2. It is good to hear all cancer was gone when you had your biopsies. Either the BCG is working or your tumor was low grade and has not recurred. But aren't all bladder cancers "gone" until they recur? Depending on your type and grade the BCG is warrented. So, yes, if your type was initially papillary TA G1 those BCG treatments that "crippled you" was overtreatment. In the letter you posted to and from Dr. Lamm yesterday you stated you are do for 3 more BCG treatments. Gee, I am confused for you and concerned. Rosie - Rosie

Superficial BC vs. Metastatic BC

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