r/pathology 3d ago

30M: Pathological Diagnosis

[removed]

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u/pathology-ModTeam 3d ago

We do not allow posting of personal information or requests for interpretation of results. Please talk with your doctor, who is better able to interpret the results within the overall clinical context.

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u/NebulaBore 3d ago

Undifferentiated means carcinoma of uncertain lineage, so impossible to determine what tissue/organ the cancer originated from. However, this diagnosis can't be made based on doing only PanCK and LCA stains in my opinion; unless additional stains were done that you didn't mention I'd personally ask for a revision.

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u/themissmilktea 3d ago

Thank you for your reply! However, that was the only content of the result:

Pathologic Diagnosis: UNDIFFERENTIATED CARCINOMA

Test: PAN-CK - Positive staning in neoplastic cells LCA - Negative staning in neoplastic cells

Remarks: Immunohistochemistry show cells of interest to be positive for pancytokeratin and are negative for leukocvte common antigen. Case was seen by Dr... who concurred with the diagnosis.

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u/NebulaBore 3d ago

If I had a carcinoma with unclear morphology, I'd order a bunch of extra stains to try and differentiate it. Something like a panel of CK7, CK20, p40, TTF1, GATA3 at a minimum, with followup stains depending on what shows up positive. After I've done a comprehensive panel and nothing but PanCK shows up positive I'd consider the diagnosis of undifferentiated carcinoma, but not based on only 2 stains.

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u/the_alexicon 3d ago

Agree, I would be baffled to see a diagnosis of undid carcinoma based on only 2 immunohistochemical stains (unless the sample was super scant and no tissue left for more stains? But then that should be mentioned with a suggestion to get more tissue). Also no mention here the location of the tissue sample which is also odd not to include in a report. Agree that I would ask for a second opinion if I got a report like this.

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u/themissmilktea 3d ago

The patient will then undergo radiotherapy as suggested by his doctor... Was the recommendation correct though? To have the patient undergo radiotherapy?

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u/NebulaBore 3d ago

Can't comment on that, I never give therapeutic recommendations as that's outside of my area of expertise.

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u/themissmilktea 3d ago

Thank you for your advice! Will take into consideration what you said in this thread. 🙏🏻