pathology report

Pathology reports are terrifying. I can think of no other grouping of 8 1/2 x 11 inch paper with the potential to inflict such rack & ruin. Four measly pages, what might otherwise be considered a rudimentary book report, but with the power to turn your insides to ice water at one glance.

Reading a pathology report is a combination of a race to the finish to see if there’s anything terrible contained therein, with a good helping of “WTH does that mean??” rounded out by the distinct feeling of utter confusion. It’s also a little weird to read about your own body in such clinical, anatomical, far-removed-from-me-as-a-person way. Oh, how I would love to sit down and have a beer with Gustavo de la Rosa, MD, aka the pathologist who wrote my latest report. Since he would likely think I was stalking him, I decided to leave him alone and do my own research.

Unlike previous pathology reports, this one, from the Big Dig, seems pretty positive and full of good news, and more importantly, free of any bad news. Important distinction, that. On the first page alone, it says “No evidence of malignancy” 6 times. Holla! I also learned a new word in reading that report: papule. Any ideas what that means? Click on it to find out. My education continues; shouldn’t yours?

It’s interesting how the pathologist describes the different chunks of my body that were offered up as samples: “Received in formalin, labeled ‘left breast capsule’ is a piece of fibrous tissue measuring 12.5 x 7 x 0.3 cm. One surface is tan-pink, smooth and glistening, and the other is tan-brown and roughened with some unremarkable yellow, lobulated adipose tissue but no gross lesions are identified.’ ” I think Dr de la Rosa could have a career as a copywriter. The descriptions of the colors alone are noteworthy: who knew my innards were tan-pink, tan-brown, yellow, white-tan, and yellow-brown? There are also references to pectoralis muscle, striated muscle, intercostal muscle, cartilage, soft tissue, fragmented tissue, fibrofatty tissue and fibrous tissue, not fatty.

foreign body giant cell reaction

Long story short in the 7 categories of chunks of me that were tested is no evidence of malignancy, but evidence abounds of “foreign body giant cell reaction consistent with implant capsule” on the left, which means the left side of my body didn’t like the tissue expander placed there during the mastectomy. The right side disliked it even more, with “florid foreign body giant cell reaction.” Florid means it really didn’t like the expander. I always associate florid with rosiness or abundance, so perhaps that applies to florid foreign body giant cell reaction, as in abundant or highly developed bacteria growth. Not such a rosy picture after all. The pretty pink photo above is deceiving. When I first saw it I thought, ooooh, pretty. Then I realized that it’s some seriously ticked-off cells having a gigantic inflammatory reaction to an unwelcome visitor. Yikes.

The methodical and organized way in which the information is laid out appeals to me, with the Anatomic Pathology Diagnosis broken down into 8 sections, A through H. Each section is a different chunk of flesh that was tested and range from the tissue expander itself to left pectoralis muscle to soft tissue and lymph nodes.

The gross description of the tissue expander is pretty darn detailed: “left breast tissue expander is a flattened, spherical mesh structure with a circular plastic disc on one aspect measuring 4 cm in diameter. On one side it is inscribed with ‘Mentor’ and ‘MH 550 cc.’ This specimen is submitted for gross identification only.”

“Gross identification” doesn’t mean it was nasty, but done with the naked eye instead of under a microscope. Putting a tissue expander under a microscope doesn’t make any sense, but then again, neither does the phrase “naked eye” because when exactly do eyes wear clothing? These are the thoughts that plague me while reading about my smooth and glistening, white-tan fibrous skin.