Common Concerns

The following are common “Pathology and Laboratory Medicine" scenarios and questions asked by patients and other health care consumers. MAC is eminently Qualified and ready to answer these and other pertinent pathology and related laboratory medicine questions.

1. When I received my routine gynecologic, cervicovaginal “Pap” smear result, I was told it shows ASCUS. What is “ASCUS”, and what does it mean for my future health care?
   
   
2. A friend of mine was recently seen by her gynecologist. Instead of having a regular “Pap” smear, she had a liquid based specimen taken from her cervix. What is a liquid based“Pap”, and should I be getting this kind of “Pap” when I have my next gynecologic examination?
   
   

   Pap Smear with Parakeratosis

   
   
3. My father recently died from a massive and unexpected heart attack. An autopsy was performed and I subsequently received a detailed, 12-page autopsy report. I have no medical background whatsoever and do not understand this autopsy report, and furthermore, are any of the findings of a hereditary nature which may be of health concern to my children and me?
   
   
4. I was recently diagnosed as having HIV infection, but I have no understanding of the meaning of the various laboratory tests used to diagnose and monitor this disease. Can you help me understand these laboratory test results?
   
   
5. My 23-year-old fiancée was just diagnosed as having hepatitis C infection. We don’t understand his serology laboratory tests for hepatitis or the surgical pathology report from his liver biopsy. Can you explain these laboratory results to us?
   
   
6. My 63-year-old mother was diagnosed as having “myelodysplasia” on a bone marrow biopsy. I do not have a medical background and do not understand the bone marrow report. What is the significance of this disorder, and is it always “preleukemia”?
   
   
7. I am a 52-year-old woman with a breast mass. Because I do not work in the health-care profession, I don’t understand the diagnostic options available to me. Can you explain the difference between FNA cytology, breast core biopsy, mammotome biopsy and excisional biopsy?
   
   
8. Two weeks ago, I was diagnosed as having breast cancer. I would have greater peace of mind if I could have a “second opinion” on this biopsy. Could you review the biopsy microscopic slides, call me and personally discuss the findings with me?
   
   

   Breast Cancer with Positive Margin

   
   
9. I am a fair-skinned, 37-year-old woman of northwestern European extraction and was just diagnosed as having a skin melanoma; could you review the microscopic slides from my biopsy and also tell me something about the biology and prognostic features of melanoma?
   
   
10. Two years ago, I was diagnosed as having cancer of my right breast. Now, I have a right armpit mass. My physician wants me to have a biopsy of this mass and intends to perform Her-2-neu testing of this tissue. What is Her-2-neu testing and what types of Her-2-neu testing are available to me?
    
    
11. I am a 52-year-old man who was just diagnosed as having ischemic cardiovascular disease. Laboratory tests I’ve had performed include CRP (C-reactive protein) and cardiac troponins. Why were these tests done – and what do they mean for me?
    
    
12. At my last gynecology examination, I had a cervicovaginal specimen, and this showed HPV infection. Further evaluation determined I have a type 16 HPV infection. What does HPV infection mean and is type 16 HPV infection significant?
    
    
13. I am a 34-year-old woman who desperately wants to have children. Unfortunately, I also have an autoimmune disorder most likely representing SLE. Additionally, I have been told I have the “lupus anticoagulant” and “antiphospholipid antibody syndrome”. What do these terms mean?
    
    
14. I’m a 25-year-old woman who is having joint problems and skin rashes. A blood test shows I have a very high ANA titer and my doctor thinks I may have an autoimmune disease. She wants to do additional tests as well as a skin biopsy. Can you tell me about the blood tests used to make a diagnosis of autoimmune diseases and why does my doctor what to do a skin biopsy?
    
    
15. Two weeks ago, I had an enlarged neck lymph node biopsied, and the surgical pathology report came back as Hodgkins lymphoma. What does this mean and would you provide a “second opinion” review of these biopsy slides for my own "peace of mind."
    
    
16. My 65-year-old father was just diagnosed as having CLL. What is CLL, and what might this diagnosis mean for my siblings and me?
    
    
17. My 22-year-old sister had a breast mass which was recently sampled by FNA cytology and diagnosed as representing a “fibroadenoma”. What is a fibroadenoma? Can my sister send you her slides for a “second opinion” on this diagnosis?
    
    
    

    Fibroadenoma	Fibroadenoma

    
    
    
18. I am a 72-year-old man who recently went to a local health fair and had a blood test for “PSA”. It was elevated, and my urologist subsequently performed six prostate needle biopsies. The surgical pathology report revealed “Gleason histologic score 7, prostatic adenocarcinoma." Can you explain the PSA test to me? What is a Gleason histologic score 7 prostate cancer? For my own “peace of mind” can you look at my biopsy slides and personally call me with your “second opinion”.
    
    
19. Ten years ago, I was diagnosed as having Ulcerative Colitis. Recently, a surveillance colon biopsy showed high-grade dysplasia. What does this mean and could you review these slides and provide a "second opinion" on my case?
    
    
20. I am a heavy cigarette smoker and recently saw an ENT specialist for evaluation of hoarseness. This evaluation revealed I have a laryngeal mass which, on biopsy, was called “squamous cell carcinoma”. My ENT specialist wants to do a laryngectomy. I trust her judgment but would like a "second opinion" on the biopsy diagnosis before having such a major surgery. Would you personally review the biopsy slides and call me with your opinion?
    
    
21. My 65-year-old mother is experiencing memory loss and I am concerned she may have early manifestations of Alzheimer disease. Are there any blood or CSF tests which may be helpful in the diagnosis of this disorder?
    
    
22. My 72-year-old father has malignant cells in his right pleural cavity (lung). We are concerned about the possibility of mesothelioma. Would you review his pleural biopsy and call us with “second opinion” of this biopsy?
    
    
23. What are Prions and how are they transmitted? Is new variant CJ disease a prion disorder and, if so, how does this infection occur?
    
    
24. I'm a 32-year-old woman with a history of severe heartburn and my gastroenterologist thinks I may have “H. pylori”. Would you personally discuss with me what blood and biopsy tests are helpful in making that diagnosis and, if I do have a stomach biopsy, would you review microscopic slides to provide me with a “second opinion”?
    
    

    Helicobacter Pylori bacteria in stomach

    
    
25. My “blood counts are low” and I’ve been told I have “anemia of chronic disease”. Would you examine my peripheral blood (CBC) data and bone marrow biopsy materials and help me to understand what this diagnosis means?