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What Do My Biopsies Of Kidneys And Bladder Indicate?
Question: Dr. XXXXXXX 1/16/2014
I am scheduled for a cysto on February 13, 2015.
I had this done XXXXXXX of last year with a scope and biopsy of the kidneys and bladder.
I did not really understand the pathology report of the kidneys.
I have included the report. It does not seem to be definitive for a problem with the kidneys.
The final determination was carcinoma in siti of the bladder.
No stints were put in the ureters.
I had another cysto in october 2014 of just the bladder and a cytology of the fluids from the ureters.
The pathology determined carcinoma in siti of the bladder still present and atypical cells from the
ureters.
My question is about the cysto scheduled February 13th.
Will you be scoping the bladder and kidneys or just the bladder.
I am hoping that a biopsy of the bladder and a cytology of the fluids from the
ureters is all that is necessary to determine everything we need to know at this time.
I really do not want to have any stints put in.
That is my concern.
Thank you
XXXX
5/28/1944
Narrative
CASE: S14-15440
PATIENT: XXXX
Med. Rec. #: E0000
Birth Date: 05/28/1944
Gender: M
Location: ASC
Billing #: 0000
SSN: 0000
Ref MD: XXXXXXX XXXXXX
Date of Service: 06/23/2014
Received Date: 06/23/2014
Final Diagnosis:
A- Right renal pelvis upper pole biopsy:
-Tissue did not survive processing. See comment.
B- Left renal pelvis biopsy:
-Fragments of clotted blood and minute portion of superficial urothelial
cells. See comment.
C- Bladder biopsy:
-Fragments of bladder mucosa with foci of urothelial carcinoma in situ
with underlying acute and chronic inflammation, hemorrhage, and
granulation tissue formation.
Comment:
Specimens A and B: Multiple deeper levels of the right and left renal
pelvis biopsies were obtained with similar histology.
Dr. M. Farolan has reviewed specimen C and concurs.
Ancillary Studies:
None
Gross Description:
A- Labeled with the patient's name, medical record number, right renal
pelvis upper pole upper biopsy, received in formalin: Specimen consists
of one tiny piece of white-tan tissue measuring less than 0.1 cm in
greatest dimension. The specimen is submitted in toto in cassette A.
B- Labeled with the patient's name, medical record number, left renal
pelvis biopsy, received in formalin: Specimen consists of tiny
fragments of light XXXXXXX tissue each measuring less than 0.1 cm in
greatest dimension. The specimen is filtered through ta bag and no
tissue is grossly identified. It is submitted in toto in cassette B.
C- Labeled with the patient's name, medical record number, bladder
biopsy, received in formalin: Specimen consists of multiple pieces of
pink to yellow-tan tissue ranging from 0.1 to 0.3 cm in greatest
dimension and measures in aggregate 1.0 x 0.4 x0.2 cm. The specimen is
submitted in toto in cassette C.
ZQ/tjf
Clinical History:
Unspecified disorder of the kidney and ureter
Intraoperative Diagnosis:
None
Final Diagnosis by
XXXXXXX, MD
Electronically signed 6/24/2014
Component Results
There is no component information for this result.
General Information
Collected:
06/23/2014 12:00 AM
Resulted:
06/24/2014 5:00 PM
Ordered By:
XXXXXXXXXXX MD
Result Status:
Final result
I am scheduled for a cysto on February 13, 2015.
I had this done XXXXXXX of last year with a scope and biopsy of the kidneys and bladder.
I did not really understand the pathology report of the kidneys.
I have included the report. It does not seem to be definitive for a problem with the kidneys.
The final determination was carcinoma in siti of the bladder.
No stints were put in the ureters.
I had another cysto in october 2014 of just the bladder and a cytology of the fluids from the ureters.
The pathology determined carcinoma in siti of the bladder still present and atypical cells from the
ureters.
My question is about the cysto scheduled February 13th.
Will you be scoping the bladder and kidneys or just the bladder.
I am hoping that a biopsy of the bladder and a cytology of the fluids from the
ureters is all that is necessary to determine everything we need to know at this time.
I really do not want to have any stints put in.
That is my concern.
Thank you
XXXX
5/28/1944
Narrative
CASE: S14-15440
PATIENT: XXXX
Med. Rec. #: E0000
Birth Date: 05/28/1944
Gender: M
Location: ASC
Billing #: 0000
SSN: 0000
Ref MD: XXXXXXX XXXXXX
Date of Service: 06/23/2014
Received Date: 06/23/2014
Final Diagnosis:
A- Right renal pelvis upper pole biopsy:
-Tissue did not survive processing. See comment.
B- Left renal pelvis biopsy:
-Fragments of clotted blood and minute portion of superficial urothelial
cells. See comment.
C- Bladder biopsy:
-Fragments of bladder mucosa with foci of urothelial carcinoma in situ
with underlying acute and chronic inflammation, hemorrhage, and
granulation tissue formation.
Comment:
Specimens A and B: Multiple deeper levels of the right and left renal
pelvis biopsies were obtained with similar histology.
Dr. M. Farolan has reviewed specimen C and concurs.
Ancillary Studies:
None
Gross Description:
A- Labeled with the patient's name, medical record number, right renal
pelvis upper pole upper biopsy, received in formalin: Specimen consists
of one tiny piece of white-tan tissue measuring less than 0.1 cm in
greatest dimension. The specimen is submitted in toto in cassette A.
B- Labeled with the patient's name, medical record number, left renal
pelvis biopsy, received in formalin: Specimen consists of tiny
fragments of light XXXXXXX tissue each measuring less than 0.1 cm in
greatest dimension. The specimen is filtered through ta bag and no
tissue is grossly identified. It is submitted in toto in cassette B.
C- Labeled with the patient's name, medical record number, bladder
biopsy, received in formalin: Specimen consists of multiple pieces of
pink to yellow-tan tissue ranging from 0.1 to 0.3 cm in greatest
dimension and measures in aggregate 1.0 x 0.4 x0.2 cm. The specimen is
submitted in toto in cassette C.
ZQ/tjf
Clinical History:
Unspecified disorder of the kidney and ureter
Intraoperative Diagnosis:
None
Final Diagnosis by
XXXXXXX, MD
Electronically signed 6/24/2014
Component Results
There is no component information for this result.
General Information
Collected:
06/23/2014 12:00 AM
Resulted:
06/24/2014 5:00 PM
Ordered By:
XXXXXXXXXXX MD
Result Status:
Final result
Brief Answer:
Nature of Histo pathology about renal pelvis biopsy is not given .
Detailed Answer:
Hello
Thanks for your query .I have gone through previous thread of our discussion on your problem .
The pathologist was unable to give definite opinion about the nature of the pathology on the tissue from both the renal pelvis submitted for histopathology ,The reason being the tissues submitted were quantitatively and qualitatively not sufficient to process the samples to prepare slides for microscopic examination.
In view of the previous established diagnosis of Urothelial Carcinoma of bladder, Urologist will do examination of only bladder in your next proposed Cystoscopic examination on 13 Feb and may take biopsy of the bladder if he finds recurrence of the lesion in bladder and will not put any stent in the ureter.
Hope I have answered your query ,please feel free to ask if you have more questions I shall be happy to help you
Thanks and Regards.
Dr.Patil..
Nature of Histo pathology about renal pelvis biopsy is not given .
Detailed Answer:
Hello
Thanks for your query .I have gone through previous thread of our discussion on your problem .
The pathologist was unable to give definite opinion about the nature of the pathology on the tissue from both the renal pelvis submitted for histopathology ,The reason being the tissues submitted were quantitatively and qualitatively not sufficient to process the samples to prepare slides for microscopic examination.
In view of the previous established diagnosis of Urothelial Carcinoma of bladder, Urologist will do examination of only bladder in your next proposed Cystoscopic examination on 13 Feb and may take biopsy of the bladder if he finds recurrence of the lesion in bladder and will not put any stent in the ureter.
Hope I have answered your query ,please feel free to ask if you have more questions I shall be happy to help you
Thanks and Regards.
Dr.Patil..
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
SUMMERY OF MY CANCER
6/23/2014
Scope of kidneys and bladder with biopsy and with fulguration
Results
Kidneys ok bladder has urothelial carcinoma in situ
___________________________________________________
7/14 to 8/14
Six BCG treatments
____________________________________________________
10/2/2014
Cystoscopy bilateral ureteral catheterization with cytologies muliple bladder biopsies and fulguration.
Results
Urothelial carcinoma in situ
______________________________________________________
11/2014-12/2014
Six BCG/Interferon treatments
My question.
If the cystoscopy I am going to have on 02/13/2014 still shows carcinomal in siti of the bladder, what would be the next cource of action? What would be the next treatment?
6/23/2014
Scope of kidneys and bladder with biopsy and with fulguration
Results
Kidneys ok bladder has urothelial carcinoma in situ
___________________________________________________
7/14 to 8/14
Six BCG treatments
____________________________________________________
10/2/2014
Cystoscopy bilateral ureteral catheterization with cytologies muliple bladder biopsies and fulguration.
Results
Urothelial carcinoma in situ
______________________________________________________
11/2014-12/2014
Six BCG/Interferon treatments
My question.
If the cystoscopy I am going to have on 02/13/2014 still shows carcinomal in siti of the bladder, what would be the next cource of action? What would be the next treatment?
Another question.
Why was the samples from XXXXXXX pathology of the kidneys unusable?
Was it the cystoscopy used the factor?
Was it the skill of the urologist?
Why was the samples from XXXXXXX pathology of the kidneys unusable?
Was it the cystoscopy used the factor?
Was it the skill of the urologist?
Brief Answer:
Read detail answers below.
Detailed Answer:
hello
Thanks for follow up.
1)If Cystoscopy on 13 Feb shows recurrence of the lesion ,Urologist will again resect the tumor during same sitting .It is common practice followed all over the world.
2) Even in experts hand it is tecniquely very difficult to take tissue sample (Biopsy) from the renal pelvis by the rigid endoscope passed from the lower end of ureter into the renal pelvis because of the curvature of the ureter at Pelvi Ureteric junction.(PUJ).
Thanks and Regards.
Dr.Patil.
Read detail answers below.
Detailed Answer:
hello
Thanks for follow up.
1)If Cystoscopy on 13 Feb shows recurrence of the lesion ,Urologist will again resect the tumor during same sitting .It is common practice followed all over the world.
2) Even in experts hand it is tecniquely very difficult to take tissue sample (Biopsy) from the renal pelvis by the rigid endoscope passed from the lower end of ureter into the renal pelvis because of the curvature of the ureter at Pelvi Ureteric junction.(PUJ).
Thanks and Regards.
Dr.Patil.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
My question.
again i has 6 BCG treatments
and then 6 BCG with interferon
If the cystoscopy I am going to have on 02/13/2014 still shows carcinomal in siti of the bladder, what would be the next cource of action? What would be the next options?
again i has 6 BCG treatments
and then 6 BCG with interferon
If the cystoscopy I am going to have on 02/13/2014 still shows carcinomal in siti of the bladder, what would be the next cource of action? What would be the next options?
Brief Answer:
Depends upon the findings while doing Cystoscopy.
Detailed Answer:
Hello
Thanks for follow up.
1)If Cystoscopy on 13 Feb shows recurrence of the lesion ,Urologist will again resect the tumor during same sitting .It is common practice followed all over the world.
2) Urologist will ask for C.T Scan of the pelvis to rule out spread of the tumor beyond mucus membrane of bladder into muscles or surrounding tissue.
Thanks and Regards.
Dr.Patil.
Depends upon the findings while doing Cystoscopy.
Detailed Answer:
Hello
Thanks for follow up.
1)If Cystoscopy on 13 Feb shows recurrence of the lesion ,Urologist will again resect the tumor during same sitting .It is common practice followed all over the world.
2) Urologist will ask for C.T Scan of the pelvis to rule out spread of the tumor beyond mucus membrane of bladder into muscles or surrounding tissue.
Thanks and Regards.
Dr.Patil.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
If the cancer is still on the surface of the bladder, what will be the next step.
Would repeating the BCG interferon treatments be done again or would another
treatment be used.
Would repeating the BCG interferon treatments be done again or would another
treatment be used.
Brief Answer:
There is option of giving other chemotherapy.
Detailed Answer:
Hello
Thanks for follow up.
Normally we give 6 cycles of intravesical BCG twice .However if there is recurrence we resect the tumor and give other chemotherapeutic drugs like Mitomycin or Thitepa intravesically provided if it is proved on CT Scan to be noninvasive and confined only to bladder mucosa.
Thanks and Regards,
Dr.Patil.
There is option of giving other chemotherapy.
Detailed Answer:
Hello
Thanks for follow up.
Normally we give 6 cycles of intravesical BCG twice .However if there is recurrence we resect the tumor and give other chemotherapeutic drugs like Mitomycin or Thitepa intravesically provided if it is proved on CT Scan to be noninvasive and confined only to bladder mucosa.
Thanks and Regards,
Dr.Patil.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
can you give me your opinion as to how curable this can be.
After having 6 BCG and 6 BCG/interferon treatments, if the next scope
still shows the surface bladder cancer will the Mitomycin or Thitepa intravesically be the solution.
Since the BCG treatments are the best treatments and did not work is this cancer
just going to progress to a point where surgery(removal of the bladder) is the only solution.
After having 6 BCG and 6 BCG/interferon treatments, if the next scope
still shows the surface bladder cancer will the Mitomycin or Thitepa intravesically be the solution.
Since the BCG treatments are the best treatments and did not work is this cancer
just going to progress to a point where surgery(removal of the bladder) is the only solution.
Brief Answer:
Non invasive cancer of the bladder can be cured with repeated resection .
Detailed Answer:
Hello
Thanks for follow up.
As long as the cancer of the bladder is non invasive we do resection of the tumor multiple times as long as it has not infiltrated in surrounding tissue .This is curable completely .
The decision of giving Mitomycin or Thidepa will be taken by the concerned Urologist with consultation of Medical Oncologist who deal with various aspects of chemotherapeutic agents.
Please note that resection of the tumor or BCG does not kill all the cancer cells hence there is tendency of recurrence which is treated with repeated resection and there is no harm in doing repeated resections .
Thanks and Regards.
Dr.Patil.
Non invasive cancer of the bladder can be cured with repeated resection .
Detailed Answer:
Hello
Thanks for follow up.
As long as the cancer of the bladder is non invasive we do resection of the tumor multiple times as long as it has not infiltrated in surrounding tissue .This is curable completely .
The decision of giving Mitomycin or Thidepa will be taken by the concerned Urologist with consultation of Medical Oncologist who deal with various aspects of chemotherapeutic agents.
Please note that resection of the tumor or BCG does not kill all the cancer cells hence there is tendency of recurrence which is treated with repeated resection and there is no harm in doing repeated resections .
Thanks and Regards.
Dr.Patil.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you. That information it is reassuring.
Does a constant monitoring of the cancer keep it in check so it does not
invade the underlining tissue.
If the cancer has been there for a year, does that indicate that it is slow growing.
If it has not invaded the underlining tissue, does this indicate that it can be kept under control.
Does a constant monitoring of the cancer keep it in check so it does not
invade the underlining tissue.
If the cancer has been there for a year, does that indicate that it is slow growing.
If it has not invaded the underlining tissue, does this indicate that it can be kept under control.
Brief Answer:
Yes it is aslow growing tumor.
Detailed Answer:
Hello
Thanks for follow up.
It is definitely slow growing tumor and seems to be eradicated completely.
Yes it can be cured completely .Only thing you have to observe is to get check Cystoscopy done at frequent intervals say of 6 months for a period of 2-3 years.
Thanks and Regards.
Dr.Patil.
Yes it is aslow growing tumor.
Detailed Answer:
Hello
Thanks for follow up.
It is definitely slow growing tumor and seems to be eradicated completely.
Yes it can be cured completely .Only thing you have to observe is to get check Cystoscopy done at frequent intervals say of 6 months for a period of 2-3 years.
Thanks and Regards.
Dr.Patil.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
It has been 3 weeks since my last BCH/interferon treatment.
During the treatment period there was painful urination and
trace blood in my urine.
I still do have some but not as much painful urination and
there is still some trace amount of blood in my urine.
The blood is not visiable. I do have some test strips that indicate
a microscopic amount of blood.
I have not experienced any gross hematoma. I have not seen any
blood , clots, red, pink or brown color to my urine it has been pale yellow or clear for over 6 months other than just after
the biospies.
Why do i still have some burning and trace blood in my urine?
Are these symptoms a result of the treatment or does this indicate
that the cancer is still present?
During the treatment period there was painful urination and
trace blood in my urine.
I still do have some but not as much painful urination and
there is still some trace amount of blood in my urine.
The blood is not visiable. I do have some test strips that indicate
a microscopic amount of blood.
I have not experienced any gross hematoma. I have not seen any
blood , clots, red, pink or brown color to my urine it has been pale yellow or clear for over 6 months other than just after
the biospies.
Why do i still have some burning and trace blood in my urine?
Are these symptoms a result of the treatment or does this indicate
that the cancer is still present?
Brief Answer:
It is normal to have burning urination after BCG. infiltration.
Detailed Answer:
Hello
Thanks for follow up. It is normal to have burning urination and microscopic hematuria after BCG infiltration and nothing to be worried about .
It will get resolved gradually,
Microscopic hematuria does not suggest recurrence of cancer.
Thanks and Regards.
Dr.Patil.
It is normal to have burning urination after BCG. infiltration.
Detailed Answer:
Hello
Thanks for follow up. It is normal to have burning urination and microscopic hematuria after BCG infiltration and nothing to be worried about .
It will get resolved gradually,
Microscopic hematuria does not suggest recurrence of cancer.
Thanks and Regards.
Dr.Patil.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you so much. You have been very helpful.
Brief Answer:
Thanks for appreciation.
Detailed Answer:
Hello
Thanks for appreciation and follow up.
If you have time you can post your review about my suggestion and opinion on forum of Health Care Magic.
Thanks and Regards.
Dr.Patil.
Thanks for appreciation.
Detailed Answer:
Hello
Thanks for appreciation and follow up.
If you have time you can post your review about my suggestion and opinion on forum of Health Care Magic.
Thanks and Regards.
Dr.Patil.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
i was under the impression that i could ask any questions for a period of two days
for the one fee. It keeps saying i still have two more days to ask questions. Is this correct. The original special was like $29.95 for as many questions as i wanted.
It has been a lot longer than that.
I will be glad to post my opinion or your helpful analysis of my condition.
Again i thank you.
for the one fee. It keeps saying i still have two more days to ask questions. Is this correct. The original special was like $29.95 for as many questions as i wanted.
It has been a lot longer than that.
I will be glad to post my opinion or your helpful analysis of my condition.
Again i thank you.
Brief Answer:
Better inquire with HCM.
Detailed Answer:
Hello
Thanks for follow up.
Regarding charges you can inquire with forum on Health Care Magic .
Thanks and Regards.
Dr.Patil.
Better inquire with HCM.
Detailed Answer:
Hello
Thanks for follow up.
Regarding charges you can inquire with forum on Health Care Magic .
Thanks and Regards.
Dr.Patil.
Note: Consult a Urologist online for consultation about prostate and bladder problems, sexual dysfunction, kidney stones, prostate enlargement, urinary incontinence, impotence and erectile dysfunction - Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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