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What are the findings of the report and what does it mean?

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Pathologist and Microbiologist
Practicing since : 2006
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Question
My husbands biopsy shows Anat path reports stain results
Pancytokeratin posive
P63 cytokeratin 5. Positive/positive
Ttf1/naps in. Negative /negative
Psa. Negative
Protein. Negative
Could you please explain exactly what that means? This is the results of a fine needle aspiration, liver mass right lob
Posted Wed, 4 Sep 2013 in X-ray, Lab tests and Scans
 
 
Answered by Dr. Shailja Puri 57 minutes later
Brief Answer:
A epithelial origin tumor in liver

Detailed Answer:
Hello,
Thanks for posting your query on Health Care Magic.

The aspiration cytology report from liver mass reveals a growth in the liver.
Immunocytochemistry (ICC) is done on the aspirated cells (pancytokeratin, cytokeratin 5, PSA, TTF, protein).
ICC is a technique in which specific markers attach to specific sites on the cells depending on the origin of the cells.
Tumors can arise from various tissue and various organs.
ICC helps to know the primary site of tumor.
Positivity for pancytokeratin and cytokeratin 5 shows that the tumor has an epithelial origin.
Negativity for PSA and TTF rules out the possibility of tumor originating from prostate and thyroid/lung respectively.

Skin, GIT, urinary tract should also be examined for any growth.

If you have more queries I will be glad to answer.
Dr Shailja P Wahal


Above answer was peer-reviewed by
 
Follow-up: What are the findings of the report and what does it mean? 7 hours later
Does this mean a person is dying. They said it is untreatable. What is the best option?
 
 
Answered by Dr. Shailja Puri 56 minutes later
Brief Answer:
Treatment depends on primary site of tumor.

Detailed Answer:
Hello and welcome again,

No, it does not imply that one is dying.
The further management depends on the site of primary tumor.
The prognosis is dependent on the primary site of tumor.
If the primary site of tumor is large intestine, resection of affected intestine and lump in the liver helps and has encouraging 5 year survival.
If the primary site of tumor is skin e.g. melanoma, the liver lump is unresectable, carries poor prognosis and poor 5 year survival.

So, further management and prognosis depends on primary site of tumor.

Thanks
If you have more queries, I will be glad to answer.
Dr Shailja P Wahal.
Above answer was peer-reviewed by
 
Follow-up: What are the findings of the report and what does it mean? 1 hour later
He is in excruciating pain. They say it is untreatable. MALIGNANT CELLS PRESENT. KERATINIZING SQUARMOUS CELL CARCINOMA is the biopsy final cytologic diagnosis. They had a fine needle aspiration liver mass right lobe.
 
 
Answered by Dr. Shailja Puri 28 minutes later
Brief Answer:
Opoid analgesics and/or nerve division for pain

Detailed Answer:
Hello and welcome again,
As I mentioned previously that the prognosis will depend on the primary site of origin.
The squamous cell carcinoma, keratinizing type is a tumor with epithelial origin (in corroboration to ICC results).
The squamous cell carcinoma arises from skin, head and neck region, upper aero-digestive tract, lung, and anal canal region. These are msot common sites of origin.
The possibility of tumor arising from lung has been already ruled out by negative TTF.
Since, the squamous cell carcinoma is fraternizing, skin is the most probable site.
A primary tumor arising in skin and metastasizing to the liver carries poor prognosis and poor 5 year survival.
The primary site of tumor can be resected (if possible) and other measures can be taken to reduce the discomfort and pain associated with the tumor.
The pain which you have mentioned can be controlled with opoid analgesics or division of the nerve supplying that area.
You need to consult an oncologist for palliative care.

Thanks and take care
Dr Shailja P Wahal
Above answer was peer-reviewed by
 
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