The Histopathology Report

The specialist doctor who does the examination under the

microscope is called a Pathologist. The tissue that is studied comes
from a biopsy or surgical procedure whereby a sample of the
suspect tissue is selected and sent to the laboratory. It is then
processed and cut into very thin layers (called sections), stained
and examined under microscopes to characterize the details of the
cells in the tissue. For some diseases, the surgeon can get a
sample of the tissue interpreted very quickly through the use of
frozen sections. Frozen sections or slices are used sparingly in
lymphoma, however, due to problems in interpretation and
sampling. In lymphomas, lymph nodes are the tissue most
commonly examined in histopathology. For many types of blood
cancers, a bone marrow biopsy may also be required for a definitive
diagnosis.

Components of the Report

Histopathology reports on surgical cancer specimens are getting
more and more complex. They may include:

• The microscopic appearance of the involved tissue

• Special stains
• Molecular techniques
• Other tests

Molecular techniques refer to the ability to analyze cells and tissues

at the molecular level, which is at the level of proteins, receptors,
and the genes that code for these things.

Interpreting the Report

Many of the findings from such examination of the tissues are linked
to prognosis. Prognostic indicators may include tumor grade and
extent of spread, and whether or not the cancer was removed with
a margin of healthy cells surrounding it, or if there is evidence the
cancer has spread beyond what was removed.
Grading systems differ depending on the kind of cancer being
graded, but generally the cells are scored based on how abnormal
they appear under the microscope, with Grade 1 tumors being more
normal looking and Grade 4 tumors reflecting more abnormalities. A
high-grade tumor, then, is generally one in which the cells have
more abnormalities. Grading is not the same as staging. Staging
has more to do with where the cancer is found in the body and how
far it has spread.