2nd opinion on slides -- still no grade #

Kimberly,

If your BCG is the same day as the concert, you could skip one and make it up later. Sometimes they have to skip it if there is blood in the urine or any other situation going on. If it is a couple of days before the concert, it will likely not be a problem.

Mike

here's an interesting article on von brunns nests...can be a stumper for some pathologists...read all the way down
www.nature.com/modpathol/journal/v22/n2s/full/modpathol2008201a.html

pat

Thanks, jj and Mike. Both pathology reports indicate no muscle invasion, but it was the absence of a number for that grade that had me puzzled. Thanks for explaining the low/high vs. 1-2-3 system.

I had my follow-up today, and we scheduled my 6 BCG treatments starting on 11/17. I'll be done the week of Christmas. Ho! Ho! Ho!

Bad news is that the fourth BCG (Tuesday 12/7) is the same week as my orchestra's Christmas concert. I sure hope I'm able to perform that concert ... joyful music that's not too hard. My heart and soul could really use that.

My uro is following Dr. Lamm's protocol of followup treatments, so he suggested -- assuming that I can tolerate it -- 3-week BCG treatments at the 3-month, 6-month, 9-month and 12-month points. My poor septic tank ...

JJ is right. I was thinking Stage. Sorry about that.

In bladder pathology there are several different grading systems. I think the one used at JHU is high grade vs low grade so a number is not necessary. This is the most recent WHO recommendation for grading, although many pathologists still use a 3 grade system with 1 = low grade, 3 = high grade, and 2 = intermediate. In the 2 grade system most of what was called 2/3 would become high grade. I think what Mike refers to is stage which is based upon the extent of the tumor: non-invasive, carcinoma in situ, lamina propria only, muscle wall, and beyond muscle wall. Usually, stage is a more important determinant of treatment and prognosis than grade. Best wishes,

jj

Here is a link to John's Hopkins explaining how to interpret a bladder biopsy pathology report.
apps.pathology.jhu.edu/blogs/bladder/?tag=muscularis-propria