Pathology Report in Hand- vague

[DebE13]

I finally have my pathology report from my colonoscopy a few weeks ago. There are five points under the final dx area. Three are for each of the polyps removed and tested. The forth lists "Biopsy in the terminal ileum: ileal muscosa with prominent lymphoid aggregates, otherwise unremarkable. No active/chronic ileitis, dysplasia or malignancy." The last point lists: "Biopsy of the whole colon: collagenous (microscopic) colitis. Morphologic features of ideopathic inflammatory bowel disease not identified. Comment: note is made for request for tryptase staining, however given the classic hallmark findings of CC, the staining is felt not to be medically indicated in this case." It is then followed by a picture a biopsy slide.

Now that they are actually doing the stain that was originally ordered, do I need to be concerned about the competency of the lab? I'm not familiar with how they do the test but does it take a certain amount of skill to complete it or is it pretty straight forward once they know what they are supposed to be looking for?

I was hoping for some sort of reference to compare the state of my condition since the original dx. Although maybe it doesn't matter since I have no doubt it's there.


Any ideas why a pathologist would decide it was not necessary? I find it very perplexing.

[tex]

Now that they are actually doing the stain that was originally ordered, do I need to be concerned about the competency of the lab? I'm not familiar with how they do the test but does it take a certain amount of skill to complete it or is it pretty straight forward once they know what they are supposed to be looking for?

Once they do the stain, counting the mast cells should be as easy as falling off a log. It shouldn't be any more difficult than counting T cells in order to diagnose or rule out LC. It's possible to count mast cells without using the special stain. The stain just makes it a lot easier to see the mast cells, so that thedy can be more accurately counted.

Any ideas why a pathologist would decide it was not necessary? I find it very perplexing.

My guess would be that the pathologist doesn't consider mast cell numbers to be relevant/important as far as digestive system issues/IBs are concerned. He or she probably thinks that mast cells are associated with hay fever, asthma, anaphylaxis, etc., and they're the domain of immunologists, not GI docs. IOW, the pathologist probably assumed (correctly) that your GI doc wouldn't know what an elevated mast cell count meant anyway, so why waste time staining the slides and making a count?

I can guarantee that it never occurs to doctors that the patient might know more about a medical issue than the doctors involved. That's not even on their radar.

Tex