Pathology Report Finally - HUH????

[femmyreyn]

I received my pathology report today. I guess they really don't know what it is at all.

Intraoperative Diagnosis:
Cytologic preperation suggests pilocytic astrocytoma - tissues show reactive astrogliosis.

Differential diagnosis:
1. Demyelinating lesion (such as MS)
2. other inflammatory lesion
3. changes to an unsampled lesion (which may be neoplastic)

So basically I am in the same place I was back in May after 3 sets of MRIs, 2 CT scans, 2 spinal taps, and a laminectomy with "tumor resection".

Can someone tell me... is this normal?? I feel so ABBY-normal (used that word forever -sorry) right now.

[Todd]

looks like an astrocytoma to me. i got the differential diag. stuff on my path. as well. guess it gives the doc other things to look for should other symptoms or something come up.

according to my quick research, it's an anstrocytoma, which goes along with how they removed it, they are generally debulked instead of completely resected. the reactive astrogliosis is poorly understood and most likely refers to the scar inside your cord.

[kansasmom]

Have the docs gone over your report with you? I agree with Todd, it looks like they are saying the diagnosis is pilocytic astrocytoma. That would be good news, I think. How are you feeling?

[femmyreyn]

I am feeling pretty good most of the time. Some of the pain in my right arm has returned and there is more numbness in it than last week too. My leg is staying the same and it's numbness/pain depends on how much I use it.

I am quite fatigued and feeling more swelling this week but they are gradually taking me of Dexamethasone and only 7 weeks post op so I assume that's pretty normal.

When the Dr.'s "fellow" called 2 weeks ago, he explained that they think it is caused by a demyelinating disease like MS but they didn't have a difinitive diagnosis. I have a follow up Jan 31st and an appointment with their Neurlogist Feb 7.

So... this thing in my cord is an astrocytoma caused by reactive astrogliosis and is that the same as a scar/lesion caused by MS (or demyel. dis.).

I get both! HAHAHA! OY WEY I am still so confused. I will give it to God and try not to get too disappointed that there isn't a clearer picture.

[femmyreyn]

"Other cases of coincidental MS and primary CNS tumors are reviewed, as well as their possible relation."

I found this in a case of another 44 year old female.

[Todd]

no, the surgery caused the scarring inside your cord which is possibly why they say reactive astrogliosis (which is just a guess because everything I read on this indicates that it is poorly understood).

unless there were multiple lesions in your cord and brain scans, it's most likely not MS. I asked my NS about MS because that's what the first NS said when I saw him but my NS said, "multiple" means more than one. I believe they diagnose MS with a spinal tap. you also don't have spinal cord surgery, generally, with MS as the lesions go away.

[femmyreyn]

This is my first surgery and the biopsy is from that so it couldn't have caused the scarring. In researching, I see a glial scar can be a product of reactive astogliosis so the "in surgery" possible diagnosis of astrocytoma could be wrong. In talking with the "fellow", he said the doctor leaned toward that and the demyelinating disease. Glial scarring is assocated with MS and demyelinating diseases. 'Permanent CNS damage occurs early in the disease due to loss of axons and associated glial scarring'

I am understanding more now but it's all so confusing still. All the research helps me form questions and understand terms better so I will be prepared when talking to the doctor.

[Todd]

what you say could indeed be correct. who knows. however, you do have scarring after the biopsy. any cutting into the body leaves scarring or are you saying that the MRI prior to surgery shows scarring? or the MRI post op shows scarring. If there's scarring prior to surgery, then you do indeed have a bit of a mystery going on. post-op scarring in the cord would be present and normal, though.

[femmyreyn]

Pre op scarring. I have not had post op appointment yet because they forgot to schedule post op MRI before
I am at the neurologist right now... They had a cancellation and I got it so I don't have to wait til Feb 7!!!! Should get called in soon!!

[Todd]

ah, thanks, yeah, that is different.