Mkay, told someone to send a case to BWH..

[LADoc00]

I looked over another pathologist's case and told em I was worried about choriocarcinoma in a molar pregnancy. He likewise was worried so we sent it to BWH because Crum is the man. Now he gets a report back that says no choriocarcinoma with pretty much no description. When I looked at it I thought (?) I saw avillous trophoblastic proliferation which was cytologically very atypical but I confess I am GTD noob in these matters....the ?s I am asking are:
1.) From the lack of a long flowing micro comment, Im thinking that fellows and residents arent writing his reports. I would expect some anal BWH resident to write in detail about necrotic villi, enlarge cytotrophoblasts with bizarre cytology etc. maybe blabbering on for at least 2 paragraphs.
2.) Am I confused about the micro criteria for a chorio arising in a mole? Someone elighten me. Ive read all the books, what is super secret tip here?

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[yaah]

I hope he didn't bill for that. I think I would either call him or send it to someone else.

Afraid I can't help you with the criteria though. I'm still stuck on what the **** a PSTT is.

 

[djmd]

Did you send a report with choriocarcinoma in it? or a letter metioning it?

Did you send blocks, maybe they cut into it and saw something different (like they found a villi on deepers?)

We usually try to comment on a question or differing diagnosis...

 

[Mr. Plow]

You should definately try to contact him and see why he came up with that result. If no response, I would have someone else take a look at it for a third opinion. I'm sure he has a good reason for making that call, however, it is poor patient care IMHO to reply in such a frank manner on a case that has pretty drastic implications.

 

[ernie]

no one is going to call cancer without deep myometrial invasion.