Pathology reports of ASPS patients

[D.ap]

My question is pertaining to the mitotic rate--
Can that be the pulse that we are looking for to discern between "aggressive "ASPS verses slow growing ASPS
Larger primary tumor + 5.5cm and higher mitotic rates as well as lymph gland possible travel.
Thanks in advance all


This is Joshua's"

Maybe Olga or Bonni could suggest a format we could follow to report the primary removal ideally .
2012-Aug 30, 2012--

2012-Male ( Joshua)
Age 32
DX Aug 30,2012
Description-
Proximal right thigh mass
Tumor site: Right side anterior
Tumor size: 6.8x5.5x3.5 cm
Macroscopic extent of tumor. Deep, subfascial , intramuscular
Histologic type: ALVEOLAR SOFT PART SARCOMA
Mitotic rate: 6/10 HPE
Necrosis: Absent
Histologic grade: Ungraded sarcoma
Margins: Negative for sarcoma
Distance from closest margin: 0.2cm dense fibrous membrane
Venous/lympo vascular invasion Present

[MartinBube]

Hi Debbie,

this is my report, it is little bit longer but i short term:
Vascular invasion can be seen
There is rarely seen atypical single mitosis up to one / 10HPF.
it is true that mitosis can be higher and lower. As I was told this that I have very low, but we will see in the future if that does make any difference.


PROVISIONAL REPORT: ALVEOLAR SOFT PART SARCOMA
Stage 1A (IF N0 M0)
T1b N? M?
DESCRIPITION OF THE TISSUE:
Post-operatively the oval fragment is weighing 10gr and has a size of 3x2.8x1.8 cm. The consistency is medium-hard and small nodules can be seen in a part of it. The colour is white to grey. In the periphery there is connective and lipid tissue and in small areas part of a muscle.
MICROSCOPY:
The tumor is built of large, uniform Epithelioid-like cells with rich eosinophilic and granulated cytoplasm. They are arranged in solid nests and alveolar structures, parted with gentle connective and vascular channels (tracks). Also there are rough-looking collagen septa with bigger blood vessels. There is a relatively clear demarcation from the surrounding structures of lipid and muscle tissue, but in certain areas there is evident infiltration of small and big tumorous nests in them. The tumorous population has relatively monomorphic big nuclei and some of them contain single eosinophilic nucleoli. There are some rare cytoplasmic nucleic inclusions. In certain zones there are mildly atypical and polychromatic nuclei. There is rarely seen atypical single mitosis (up to one / 10HPF). In the peripheral parts and the septal structures of the tissue vascular tumorous invasion can be seen.
The histochemical analysis with standard colouring is PAS negative.
Immunohistochemical analysis profile: NSE (+), Vimentin (+/- focally), Actin (+/- focally), CD117 (+/- disperse single cells), CD30 (-), CK7 (-), CK AE1/AE3 (-), CKWS (-), EMA(-), RCC (-), PLAP (-), Desmin (+/- focally), Synaptophysin (-), Chromogranin (-), S-100 protein (-), Melan A (-) and HMB45 (-).
Ki-67 shows variable proliferative index between 2% and 6% with a median value of 4%.
According to the described morphology and the above analyses the findings are described as alveolar soft part sarcoma.

[D.ap]

Martin,

PROVISIONAL precludes the final report I think?
And maybe that PROVISIONAL is only to the staging?
Anyway what the location was?
And you were 31 years old and the dx was what date?
Thank you
There could maybe somehow be a format that we could all just fill in the blanks ?
Easier to the eye and an easier read?
Anyone have any thoughts ?
Debbie

[D.ap]

http://www.cureasps.org/forum/viewtopic ... 8030#p8012


Joshua's addendum 9/05/2012
pg 2 of reort added 9/5/2012

Addedendum Comment

Immunohistochemistry results (with controls):
Negative: Vimentin,Desmin, Cytokeratin,S100,Actin

PAS with and without diastase histochemistry. Abundant cytoplasmic glycogen in tumors. Focal PAS= diastase resistant cytoplasmic crystalline materials.
The histology and immunoprofile are diagnostic ofALVEOLAR SOFT PART SARCOMA

Clinical indications
Right thigh mass

Gross description

Recieved in formalin, labeled P,- Suture proximal right thigh mass , is 148 gram, 10.8x6.8x4.0cm elongated segemt of dark red muscle with fascia along one broad edge. Ther is an orienting suture at one end. The provimal half is inked black and the distal half is inked green. Sectioning reveals a 6.8x5.1x3.1 circumscribed pink to yellow-tan nodular appearing that is 0.2cm from closest distal and 0.2cm from closest proximal margins. The mass moves freely within the muscle. A crosscut section along the longest axis of the mass is divided into five sections and submitted in 1A-1E, and additional sections showing adjacent margins are submitted in 1F-1H. BE/pd

[MartinBube]

Martin,

PROVISIONAL precludes the final report I think?
And maybe that PROVISIONAL is only to the staging?
Anyway what the location was?
And you were 31 years old and the dx was what date?
Thank you
There could maybe somehow be a format that we could all just fill in the blanks ?
Easier to the eye and an easier read?
Anyone have any thoughts ?
Debbie

Debbie, it is provisional only because of the staging, everything else is final.

My location was lower back, right side close to the spine. Basically I think this is the reason that fulled everybody it is not any ASPS or other sarcoma on the MRI

[D.ap]

Reading a pathology report

http://www.cureasps.org/forum/viewtopic.php?f=3&t=1477

[D.ap]

“Ki67 is a special stain that gives a sense of how aggressive a tumor is. The pathologist takes the biopsy or surgical specimen, prepares it, puts it on to a glass slide, stains it for this protein, and look at it under the microscope. It's a protein in cells that is involved in cell replication, so if many cells are expressing it, the tumor is growing quickly; if very few cells express it, then it is growing slowly. The pathologist needs to count about a thousand cells and determine the percentage of cells that are Ki67 positive. Therefore, the number that comes back should be a percentage from 0 - 100%.”

https://www.thehealingnet.org/blog/2015 ... eally-mean

[Andres de Mexico]

Buen día para todos, espero se encuentren perfectamente bien, mi resultado de patología también hacia referencia a un tumor con una mitosis muy baja y una necrosis ausente, recuerdo también que patología me explico que no había muchos vasos sanguíneos alimentando el tumor.
Mi pregunta para ustedes es,
La baja mitosis y la necrosis ausente, así como el haber quitado el tumor de un tamaño pequeño (15mm*8mm) con limites quirúrgicos negativos, (T1A N0 M0) ¿realmente representa algo bueno?

¿Existen ASPS menos agresivos que otros y de ser así podría ser mi caso?

Se que es demasiado lo que estoy pidiendo, pero estoy realmente desconcertado y muy asustado, ya en una semana me van a realizar una tomografía computarizada y mi fe me dice que todo estará bien con la ayuda de dios.

Pero tanto que e leído en Internet a creado un mundo en mi mente y eso me tiene aterrado.

Pero sin importar el resultado, deseo que dios los bendiga y les siga ayudando.

[D.ap]

Good day for all, I hope you are perfectly well, my result of pathology also referred to a tumor with a very low mitosis and an absent necrosis, I remember also that pathology explained to me that there were not many blood vessels feeding the tumor.
My question for you is,Good day for all, I hope you are perfectly well, my result of pathology also referredo to a tumor with a very low mitosis and an absent necrosis, I remember also that pathology explained to me that there were not many blood vessels feeding the tumor.
My question for you is,
The low mitosis and absent necrosis, as well as the removal of the tumor of a small size (15mm * 8mm) with negative surgical limits, (T1A N0 M0) really represents something good?
Are there ASPS less aggressive than others and if so, could this be my case?
I know that I am asking too much, but I am really confused and very scared, and in a week I will have a CT scan and my faith tells me that everything will be fine with the help of God.
But so much that I read on the Internet to create a world in my mind and that has terrified me.
But regardless of the result, I want God to bless you and to continue to help you.
The low mitosis and absent necrosis, as well as the removal of the tumor of a small size (15mm * 8mm) with negative surgical limits, (T1A N0 M0) really represents something good?
Are there ASPS less aggressive than others and if so, could this be my case?
I know that I am asking too much, but I am really confused and very scared, and in a week I will have a CT scan and my faith tells me that everything will be fine with the help of God.
But so much that I read on the Internet to create a world in my mind and that has terrified me.
But regardless of the result, I want God to bless you and to continue to help you.

Andres
A lot of the SEER stats say you have much going for your future prognosis . : )

“Medical Definition of SEER. SEER: The Surveillance, Epidemiology, and Ends Results (SEER) program that maintains statistics on cancer in the US. SEER is part of the National Cancer Institute.”

In reference to sarcomas in general it’s stated

“This behavior is best predicted by the histologic grade, which is determined by 4 factors: mitotic index, degree of cellularity, necrosis when present, and degree of nuclear anaplasia.”

https://www.ncbi.nlm.nih.gov/pmc/articl ... po=13.5417
And as far as ASPS goes , this was a 40 year ? Study


Search -“Prognostic Factors in Alveolar Soft-Part Sarcoma: A SEER Analysis”

H. Wang, A. Jacobson, D. Harmon, J. Michaelson, T.F. DeLaney, Y. Chen
PlumX Metrics

Conclusions: In conclusion, our SEER-based study has identified a subset of 216 patients with ASPS in which the 5-year OS rate is 57% (95% CI 50- 64%). Older age, male sex, large tumor size of >10cm, distant metastasis at diagnosis, and trunk as primary tumor site are identified as negative pre- dictors of survival. The use of radiation with surgery does not significantly impact survival rates. Because SEER is limited by lack of data concerning local control and adjuvant chemotherapy, Medicare-linked SEER datasets and detailed cohort studies are in need to further treatment options for ASPS and to address the role of adjuvant radiation therapy and chemotherapy. Author Disclosure: H. Wang: None. A. Jacobson: None. D. Harmon: None. J. Michaelson: None. T.F. DeLaney: None. Y. Chen



However never forget that you have ASPS and always keep on a scam schedule .



.

[D.ap]

Good day for all, I hope you are perfectly well, my result of pathology also referred to a tumor with a very low mitosis and an absent necrosis, I remember also that pathology explained to me that there were not many blood vessels feeding the tumor.
My question for you is,Good day for all, I hope you are perfectly well, my result of pathology also referredo to a tumor with a very low mitosis and an absent necrosis, I remember also that pathology explained to me that there were not many blood vessels feeding the tumor.
My question for you is,
The low mitosis and absent necrosis, as well as the removal of the tumor of a small size (15mm * 8mm) with negative surgical limits, (T1A N0 M0) really represents something good?
Are there ASPS less aggressive than others and if so, could this be my case?
I know that I am asking too much, but I am really confused and very scared, and in a week I will have a CT scan and my faith tells me that everything will be fine with the help of God.
But so much that I read on the Internet to create a world in my mind and that has terrified me.
But regardless of the result, I want God to bless you and to continue to help you.
The low mitosis and absent necrosis, as well as the removal of the tumor of a small size (15mm * 8mm) with negative surgical limits, (T1A N0 M0) really represents something good?
Are there ASPS less aggressive than others and if so, could this be my case?
I know that I am asking too much, but I am really confused and very scared, and in a week I will have a CT scan and my faith tells me that everything will be fine with the help of God.
But so much that I read on the Internet to create a world in my mind and that has terrified me.
But regardless of the result, I want God to bless you and to continue to help you.

Andres
A lot of the SEER stats say you have much going for your future prognosis . : )

“Medical Definition of SEER. SEER: The Surveillance, Epidemiology, and Ends Results (SEER) program that maintains statistics on cancer in the US. SEER is part of the National Cancer Institute.”

In reference to sarcomas in general it’s stated

“This behavior is best predicted by the histologic grade, which is determined by 4 factors: mitotic index, degree of cellularity, necrosis when present, and degree of nuclear anaplasia.”

https://www.ncbi.nlm.nih.gov/pmc/articl ... po=13.5417
And as far as ASPS goes , this was a 40 year ? Study


Search -“Prognostic Factors in Alveolar Soft-Part Sarcoma: A SEER Analysis”

H. Wang, A. Jacobson, D. Harmon, J. Michaelson, T.F. DeLaney, Y. Chen
PlumX Metrics

Conclusions: In conclusion, our SEER-based study has identified a subset of 216 patients with ASPS in which the 5-year OS rate is 57% (95% CI 50- 64%). Older age, male sex, large tumor size of >10cm, distant metastasis at diagnosis, and trunk as primary tumor site are identified as negative pre- dictors of survival. The use of radiation with surgery does not significantly impact survival rates. Because SEER is limited by lack of data concerning local control and adjuvant chemotherapy, Medicare-linked SEER datasets and detailed cohort studies are in need to further treatment options for ASPS and to address the role of adjuvant radiation therapy and chemotherapy. Author Disclosure: H. Wang: None. A. Jacobson: None. D. Harmon: None. J. Michaelson: None. T.F. DeLaney: None. Y. Chen



However never forget that you have ASPS and always keep on a scan schedule .



.

[D.ap]

Hi Debbie,

this is my report, it is little bit longer but i short term:
Vascular invasion can be seen
There is rarely seen atypical single mitosis up to one / 10HPF.
it is true that mitosis can be higher and lower. As I was told this that I have very low, but we will see in the future if that does make any difference.


PROVISIONAL REPORT: ALVEOLAR SOFT PART SARCOMA
Stage 1A (IF N0 M0)
T1b N? M?
DESCRIPITION OF THE TISSUE:
Post-operatively the oval fragment is weighing 10gr and has a size of 3x2.8x1.8 cm. The consistency is medium-hard and small nodules can be seen in a part of it. The colour is white to grey. In the periphery there is connective and lipid tissue and in small areas part of a muscle.
MICROSCOPY:
The tumor is built of large, uniform Epithelioid-like cells with rich eosinophilic and granulated cytoplasm. They are arranged in solid nests and alveolar structures, parted with gentle connective and vascular channels (tracks). Also there are rough-looking collagen septa with bigger blood vessels. There is a relatively clear demarcation from the surrounding structures of lipid and muscle tissue, but in certain areas there is evident infiltration of small and big tumorous nests in them. The tumorous population has relatively monomorphic big nuclei and some of them contain single eosinophilic nucleoli. There are some rare cytoplasmic nucleic inclusions. In certain zones there are mildly atypical and polychromatic nuclei. There is rarely seen atypical single mitosis (up to one / 10HPF). In the peripheral parts and the septal structures of the tissue vascular tumorous invasion can be seen.
The histochemical analysis with standard colouring is PAS negative.
Immunohistochemical analysis profile: NSE (+), Vimentin (+/- focally), Actin (+/- focally), CD117 (+/- disperse single cells), CD30 (-), CK7 (-), CK AE1/AE3 (-), CKWS (-), EMA(-), RCC (-), PLAP (-), Desmin (+/- focally), Synaptophysin (-), Chromogranin (-), S-100 protein (-), Melan A (-) and HMB45 (-).
Ki-67 shows variable proliferative index between 2% and 6% with a median value of 4%.
According to the described morphology and the above analyses the findings are described as alveolar soft part sarcoma.

Martin how old were you when you were dx’d ?