The Pathology Report
While you will meet your surgeon and anesthesiologist before your surgery, there is one medical professional that will participate in your surgery that you will likely never meet. Even though you will probably never meet this physician, a pathologist plays a role in almost every surgery. Even in procedures that are not often considered surgery, such as colonoscopy, require the services and expertise of a pathologist. A pathologist will take tissues or certain fluids that have been removed from your body and analyze them under a microscope. A large amount of information about you and your disease can be determined from what is seen on these microscopic slides. This information is described, summarized and interpreted on a document called a pathology report. This pathology report will be used by your doctor and surgeon to direct your care. You may get a copy of this pathology report and, if you do, you should know what it says and what it means for your health and your life.
If you have concerned about your pathology report you should go over it thoroughly with your physician. While your internist did not perform the pathology analysis, they will be able to explain the results and their significance for you.
The pathology report will contain information regarding the type of tissue included in the specimen. It may list things like “distal colon” or “anterior superior pole of the kidney.” This tells you where in the body the sample was taken. A line marked Diagnosis will be included on the pathology report. This is essentially the summary of the report. It will usually be written using medical jargon such as “poorly differentiated squamous cells suggesting metastases” or “inflammation involving the mucosal layers.” With a bit of work you should be able to decipher this information but, again, you should ask your physician to translate this for you and discuss its meaning and importance. This diagnosis is based on what the pathology sample looked like and a (usually very limited) description of your case.
There will also be a gross description and microscopic description included on the pathology report. The gross report is not a comment of how disgusting the sample looks but rather how it looks to the naked eye (without a microscope). The microscopic description is, as the name states, what the sample looks like under a microscope. Both the gross and microscopic descriptions can provide useful information to the pathologist and other physicians. When cancer spreads, for example, it may cross some natural boundaries in the healthy tissue. This may be better appreciated simply by carefully looking at the specimen. On the other hand, individual cells will begin to change appearance as they move from healthy to unhealthy. This is only seen with the use of a microscope. Sometimes special stains must be used in order to differentiate between different features of the cells and between cell types. This information will also be noted on the pathology report.
The pathology report, constructed by a pathologist, is a critical piece of many surgical procedures. It is important for doctors that participate in your care to have this report but also that they explain it to you to your satisfaction. While the report is written by doctors for doctors, the information contained on it is about you—based on your tissue—and you should talk to your doctor about what it says and what it means.