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Report Showed Small Cells. Mixed Inflammatory Cells With Cytoplasm And Vesicular Nuclei. What Does It Indicate?

Posted on Thu, 23 May 2013

Question: my report says occasional small clusters of small atypical cells with scanty to moderate amount of cytoplasm and vesicular nuclei.Background show mixed inflammatory cells.Although,material obtained is suboptimal ,features are suggestive of metastatic undifferentiated carcinoma .
Explain in layman terms please

Answered by Dr. Indranil Ghosh (1 hour later)

Hi
Thanks for writing in.

It appears that you have got an enlarged lymph gland in upper neck from which an FNAC (fine needle aspiration) has been done. It reveals a cancer, the source of which is not clear. This type of cancer (carcinoma) does not arise from lymph gland but comes from some other site. Most commonly from some site in mouth, gums or throat.

You will need a comprehensive clinical examination to find out the source. If something is found then it has to be biopsied to confirm. Otherwise a Positron emission tomography (PET) scan may be done to locate the primary source. PET will also give idea about the stage.

After these, the definitive treatment plan will be made (eg, surgery and/or radiation and/or chemotherapy). The outcome depends on the primary and the stage.

Hope I have answered your query. I will be happy to answer any follow-up queries.
Best Wishes,

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Indranil Ghosh (1 hour later)

Thank You for this Dr XXXXXXX May I ask which institution in India provides the best facilities for such an examination to be conducted?
Thank you.

Answered by Dr. Indranil Ghosh (10 hours later)

There are many centers. Please let me know which city you are in and then I can suggest.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Indranil Ghosh (1 hour later)

I am in Dimapur Nagaland.
The closest "city" by rail air and road is Guwhatai,Assam where the "B Baruah Cancer Institute" is located.
Of course Kolkata is also connected by non stop flight.
So is Delhi or Mumbai.via Kolkata so the flights take longer and are more expensive.

My concern is to access a hospital/center of repute which will conduct a foolproof test and also provide the follow up treatment,counsel and treatment for a cancer patient.
Because it seems to me that "cancer" cells have been detected but we have to establish the primary and its stage.Is that correct?
Thank You,you have been patient,brief consise and kind.

Answered by Dr. Indranil Ghosh (53 minutes later)

My suggestions for you (not in any particular order)

1. TMH Mumbai
2. Tata Medical Center Kolkata
3. AIIMS New Delhi
4. XXXXXXX XXXXXXX Cancer Center, Delhi

You can also consult Dr XXXXXXX Kayal at B Barooah cancer center first and take her opinion.

As I have said the location of primary and stage are important.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Indranil Ghosh (12 minutes later)

Dr XXXXXXX
When you suggested PET was it PET CT or PET MRI the latter which I just read was launched in New Delhi in February this year.
Or is this a detail the doctors who will carry out the treatment will decide?
Thank you.

Answered by Dr. Indranil Ghosh (10 hours later)

Exact plan will be made after clinical assessment by doctor.

Note: For further queries related to kidney problems Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar