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What Does My Lab Test Report Indicate?

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Posted on Wed, 4 Jan 2017
Question: Can you please explain what the attached means? Do i have cancer? If so have they got it all or is there a possibility it has spread?
doctor
Answered by Dr. T Chandrakant (1 hour later)
Brief Answer:
As discussed in details below.

Detailed Answer:
Hi.
Thanks for your query.
To recapitulate: Female/35 - wants to know about the attachments - is it cancer - whether removed all - any possibility of spread. ..

As per the reports you have posted, this is carcinoid tumor of appendix, measuring 6 mm, invasion up to meso-appendix.
Yes, this is a type of cancer that comes from the mucosa of the gastrointestinal mucosa and hence carcinoid.
Since it coming from the tip of the appendix and is only 6 mm in size, appendectomy alone may be sufficient but since the invasion is outside the wall of appendix into the mesoappendix, strictly further evaluation and investigations and further management has to be done.
Since mesoappendix is removed with appendix and there is no invasion or spread into the blood vessels and perineural tissues, possibly whole disease is removed.
I would advise the following:
Consult your Surgeon or Onchosurgeon for clinical evaluation whether you have got any symptoms of Carcinoid syndrome like flushing of head and upper part of thorax, diarrhea, breathlessness or any cardiac problems.
24-hour urine levels of 5-HIAA (5-hydroxyindoleacetic acid)
CT scan of abdomen to see for any remnant.
If all the tests are negative, you may most probably be free of any spread.

I hope this answers your query, please feel free to ask for further relevant queries if you feel that there is a gap of communication.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant (6 hours later)
If it has spread what is the normal treatment framework?
doctor
Answered by Dr. T Chandrakant (19 minutes later)
Brief Answer:
As detailed below.

Detailed Answer:
Will depend upon the investigations telling about the spread.
The protocol is strictly followed as decided by the Center you are taking treatment in.
So first of all it is necessary to undergo the imaging investigations as available at the center and urine tests as indicated above to decide whether further management would be necessary and if yes, what would be necessary.
You will have to keep a regular follow up with the treating Doctor and get periodic investigations to see for any remnant or recurrence and spread an treated accordingly.
This can be nothing if no secondary is found.
This can be either chemotherapy and surgery as the case may be presented with....
I hope this gives you the guidelines of the management.
Please feel free to ask for further relevant queries if you feel that there is a gap of communication.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant (17 minutes later)
Sorry, I am just soworried and don't understand the medcial words, so in lay terms what does this sentence mean "immunohistochemical stains show that the tumor cells are positive for chromogranin and synaptophysin".
doctor
Answered by Dr. T Chandrakant (12 hours later)
Brief Answer:
As explained below.

Detailed Answer:
"immunohistochemical stains show that the tumor cells are positive for chromogranin and synaptophysin".
This means : While dong the staining of the slides by "immunohistochemical method the cells have been positive for Chromogranin and Synaptophysin and is fully confirmatory of carcinoid tumor and hence confirmed to be carcinoid tumor....
They serve as markers for diagnosis and evaluation. Positive immunohistochemical staining for Chromogranin (Cg), Synaptophysin provide necessary evidence for the definitive diagnosis of a tumor of neuroendocrine origin and are the markers associated with all carcinoid tumors.

I hope, this answers your query.
Please feel free to ask for further relevant queries if you feel that there is a gap of communication.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. T Chandrakant (2 hours later)
In your opinion, do you think the cancer has spread?
doctor
Answered by Dr. T Chandrakant (2 hours later)
Brief Answer:
Needs evaluation as already mentioned above.

Detailed Answer:
Hi.
As mentioned above, it needs a detailed study to know whether the cancer has spread or not.
There can not be any hypothesis as the further management and follow-up depends upon the factual things.
Please follow the guidelines as would be set by your Oncologist.
Note: For further inquiries on surgery procedure and its risks or complications book an appointment now

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. T Chandrakant

General Surgeon

Practicing since :1984

Answered : 19779 Questions

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What Does My Lab Test Report Indicate?

Brief Answer: As discussed in details below. Detailed Answer: Hi. Thanks for your query. To recapitulate: Female/35 - wants to know about the attachments - is it cancer - whether removed all - any possibility of spread. .. As per the reports you have posted, this is carcinoid tumor of appendix, measuring 6 mm, invasion up to meso-appendix. Yes, this is a type of cancer that comes from the mucosa of the gastrointestinal mucosa and hence carcinoid. Since it coming from the tip of the appendix and is only 6 mm in size, appendectomy alone may be sufficient but since the invasion is outside the wall of appendix into the mesoappendix, strictly further evaluation and investigations and further management has to be done. Since mesoappendix is removed with appendix and there is no invasion or spread into the blood vessels and perineural tissues, possibly whole disease is removed. I would advise the following: Consult your Surgeon or Onchosurgeon for clinical evaluation whether you have got any symptoms of Carcinoid syndrome like flushing of head and upper part of thorax, diarrhea, breathlessness or any cardiac problems. 24-hour urine levels of 5-HIAA (5-hydroxyindoleacetic acid) CT scan of abdomen to see for any remnant. If all the tests are negative, you may most probably be free of any spread. I hope this answers your query, please feel free to ask for further relevant queries if you feel that there is a gap of communication.