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Does anyone who has been diagnosed with typical carcinoid think that a tumor could contain both typical and atypical cells.
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lung tumors ?
- By sitamouse
- Posted May 1, 2009 at 9:17 am · 9 replies
- In What, me worry?
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- By liligoldman
- Posted May 1, 2009 at 12:59 pm
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I think it's possible, but I think that any good pathologist would catch it, and probably that would make the tumor "atypical" by default.
Basically the distinction of typical/atypical is a measure of how many "mitoses" a tumor has when a pathologist looks at it under the microscope. I don't know exactly what "mitoses" are but I think it has to do with how quickly the cells are replicating. The higher the number of mitoses, the faster the cancer cells are replicating. My research tells me that if a pathologist discovers that you have more than 2 mitoses per slide than you are automatically "atypical." If you have less, than you are "typical". If you get a copy of the pathologist report of your tumor it will tell you how many you had. The less the better! I had less than 1, so I am in good shape and definitely typical.
Hope this helps!
- By leehee1
- Posted May 9, 2009 at 5:23 am
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How was you pathology done?
If it is a biopsy (small tissue sample) then often pathologist will miss the atypical diagnosis.
There are reports that people have mixed tumors - so the answer is yes, you can have both typical and atypical.
The number of mitoses is what is important. Atypical would be considered if the mitoses are above 7-10 per slide. There are controversies regarding the exact level but 2 as the previous poster said would still be considered typical.
I myself have 5 - considered moderately aggressive.
But basically with carcinoid, even people with typical counts can metastasize. On the other hand, it has been shown that the more atypical you are, the better "ordinary" chemotherapy will have an effect.
Good luck
- By snowflower
- Posted May 9, 2009 at 4:13 pm
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I do not post very often. I have been so blessed to have this board to read so I can gain some knowledge.
I had a 1.7 cm MIXED adenocarcinoma, lower right lobe removed and middle right lobe wedged (VAT). I never realized until this very moment in reading this that there was typical and atypical. All new to me. I am really appreciating this conversation and I do have my Pathology report and plan to read through it to look for "mitoses" mentioned.
BTW....I had my first CAT Post Surgery last week and they say NED. I am scheduled to scan again in 6 months. I can hardly believe it. I fell to my knees and cried when I heard it.
- By Isunique
- Posted May 9, 2009 at 4:23 pm
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Congrats on NED Snowflower, great, great news.
Sarah
- By liligoldman
- Posted May 9, 2009 at 5:14 pm
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Hi Snowflower -
Just to be clear: the diagnosis of typical vs. atypical, if I am not mistaken, only applies to "carcinoid" tumors, but NOT to adenocarcinoma, which is a different kind of lung cancer. I'm not sure what "mixed" adenocarcinoma means - maybe it still refers to the number of mitoses...? Check your pathology report...
On another note, I agree with leehee1 that a biopsy is only a small sample, so that is not necessarily the best for catching all aspects of the tumor, be they typical or atypical. My pathology report was done on many different sections of my tumor, which is usually the case when entire tumors are removed.
Even though a larger tumor and mets to local lymph nodes might not be the best prognostic factors, all of us who have carcinoids still have really great odds for NO reoccurrence, particularly if we have good, experienced surgeons adept at removing all the cancer cells. I myself am only 27 years old, but had a 4.0x4.5cm carcinoid with mets to local lymph nodes, and STILL my odds of reoccurrence are infinitessimally small, particularly because my margins were clear and, in removing a significant amount of my lung, they removed ALL of the tumor. NO cancer cells were found in any other lymph nodes. So they removed it all.
Age is also another important prognostic factor. The younger a person is, the more chances they have for no reoccurrence. But yes, we all have to be monitored for life, most aggressively during the first few years after our diagnoses.
- By snowflower
- Posted May 9, 2009 at 6:16 pm
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liligoldman...thanks for the information. I thought they were both the same. I am learning. I am so sorry to hear that at such a young age you are dealing with this issue. I will, always keep you in my thoughts and prayers. I checked my Pathology report and it said Adenocarcinoma - acinar and solid growth patterns - no spread to lymph nodes.....said nothing about mitosis. Bless you! Snowflower
- By liligoldman
- Posted May 10, 2009 at 11:46 am
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Thanks, snowflower! I really appreciate your thoughts and prayers, they really mean a lot. I too will keep you in mine, and Congrats! on being NED. I have my first CAT on June 17th and already I have scanxiety.
Best
Liliana
- By rmhayes
- Posted May 10, 2009 at 3:57 pm
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I am one of those with a tumor that has mixed cells. Long and short of it end diagnosis for me was: Extensive Sclc and NSCLC and mixed cell. Pathologist and Oncologist went back and forth over the final report. I had 3 separate samples done. I wasn't eligible for surgery due to the spread of the small cell into lymph nodes. So, it does happen but like all diseases i have had...its rare.
robin
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