Question: Hello,

I had an abnormal pap smear about two years ago which I underwent a surgery for but never went back for the pathology report. For the last 7 months I have been having vaginal bleeding. I have a copy of my pathology report but don't really know what the meaning of my diagnosis is and was wondering if you could put it into easier terms for me. I haven't been back to see my doctor since. I will attach the report below.

Pathology Report:
Notes:
Surgical Pathology Consultation Report


SPECIMEN(S) RECEIVED

1. Vulva: RIGHT ANTERIOR LABIA - MARKED AT 12 O'CLOCK





DIAGNOSIS

1. Vulva, right anterior labia, resection:

Invasive squamous cell carcinoma, moderately differentiated, non-keratinizing:

- Maximum depth of invasion 4.8 mm

- Maximum tumor thickness 7.2 mm

- Negative for lympho-vascular invasion

Extensive high grade squamous intraepithelial lesion (VIN 3):

Margins:

- one lateral margin (12-3-6 o'clock) positive for invasive squamous cell carcinoma

- second lateral margin (12-9-6 o'clock) positive for HSIL

- deep margin is negative for HSIL or invasive carcinoma





COMMENT

Immunohistochemistry for p16 shows diffuse overexpression in the invasive carcinoma and HSIL, supporting the impression of an HPV-associated malignancy.



SYNOPTIC DATA



SPECIMEN

Specimen: Vulva

Procedure: Local excision

Lymph Node Sampling: Not applicable

Specimen Size: Greatest dimension (cm): 2.5

Tumor Site: Other: Right anterior labium

Tumor Size: Greatest dimension (cm): 1.3

Tumor Focality: Unifocal

TUMOR

Histologic Type: Squamous cell carcinoma

-Non-keratinizing

Histologic Grade: G2: Moderately differentiated

EXTENT

Microscopic Tumor Extension: Depth of invasion (mm): 4.8

Tumor Border: Infiltrating

MARGINS

Involved by invasive carcinoma

-Specify Margin(s): --Specify margin(s): 3 oclock- medial

ACCESSORY FINDINGS

Lymph-Vascular Invasion: Not identified

LYMPH NODES

No nodes submitted or found

STAGE (PTNM [FIGO])

Primary Tumor (pT): pT1b [FIGO IB]: Lesions more than 2 cm in size or any size with stromal invasion more than 1.0 mm, confined to the vulva or perineum

Regional Lymph Nodes (pN): pNX: Regional lymph nodes cannot be assessed

Distant Metastasis (pM): Not applicable

ADDITIONAL NON-TUMOR

Additional Pathologic Findings: Vulvar intraepithelial neoplasia (VIN) 3 (severe dysplasia / carcinoma in situ)

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GROSS DESCRIPTION

The specimen labeled with the patient's name and as "Vulva: Right anterior labia - marked at 12 o'clock" consists of an oriented piece of mucosa marked with a suture at 12 o'clock position measuring 2.5 cm from 12 to 6 o'clock x 1.7 cm from 3-9 o'clock x 0.7 cm in thickness received in 10% buffered formalin. The 12-3-6 o'clock margin is painted with green XXXXXXX and the 12-9-6 o'clock margin is inked with XXXXXXX ink. The specimen is submitted in toto as follows:

1A- 12 o'clock margin perpendicular sections

1B-1D- remainder of the specimen serially sectioned from 12-6 o'clock

1E- 6 o'clock margin perpendicular sections

Hello,

Thank you for your response. I was wondering is this suggestive of cervical cancer as well? And does my bleeding have anything to do with the cancer? Also, how far/ what stage was the cancer when the pathology was done.