Re: Re: Angio/Vascular Invasion-->, Anybody?

[Guest guest]

Dear Anita,

I apologize for ignoring your questions.

Actually, I have your letter highlighted in my inbox; I was hoping

someone else would write in with the answers, since I wanted to do some

research first.

I don't have any official resources for it at the tip of my fingers, so I

will tell you what I know (or think I know), and get back to you after I've

had a chance to dig through my files.

I'll start with the easier ones first.

- " ....there was some parathyroid gland present in the left lobe. The

surgeon apparently didn't see that she

had taken some of the parathyroid gland. "

I'm not sure if this is actually a question or not, but it is not uncommon

to lose a parathyroid or two during thyroidectomy surgery, and that's

generally not a problem. We have four of them, and they're apparently

small and tricky little things, easy to miss and sometimes difficult to

save. My surgeon agreed with my analogy that the parathyroids are like

yellow jello pearls in an orange jello thyroid. Often a surgeon can

replant a parathyroid into a nearby muscle. Most of us can function

quite well with only two or three, often even one. (you can read more

about parathyroids at http://www.endocrineweb.com/parathyroid.html)

- ' " ... around the periphery of the nodule, vascular invasion by tumor is

present'. This is describing the left lobe that had the larger papillary

tumor. It was stated to be " thinly encapsulated " .

Thinly encapsulated is not bad. Better than capsular invasion, not quite as

secure as well encapsulated. Tumors that have invaded the capsular wall

tend to have a higher incidence of recurrence, although by most standards,

even recurrence, if it remains localized (within the neck), does not affect

ultimate mortality rate.

- " The other statement is in the diagnosis of the left lobe " papillary

carcinoma, follicular variant, with angioinvasion " . "

I don't recall hearing the phrase " angioinvasion " , but I think it is the

same as " vascular invasion " , meaning that evidence of thyca cells have been

seen in the blood vessels. This goes back to Amy's question, " can a tumor

that is encapsulated in the thyroid spread to your lymph nodes without

first spreading to your thyroid? "

What I would have answered (but hoped someone else would, with total

certainty or documentation) is yes, I'm rather certain that there can be

spread outside the thyroid without having evidence of spread within the

thyroid gland. I've never seen this addressed directly, but my assumption

is that the more thinly encapsulated the tumor is, the more likely this is.

As for Amy's second question,

> Does everyone who has spread to the lymph nodes have " VASCULAR invasion " ?

> Or does that mean something different?

Again, my understanding is that absolutely, if there is thyca malignancy

outside of the gland, it constitutes " vascular invasion " . It does not,

however, necessarily mean that the cancer will be seen outside the tumor

within the gland, or even in the vessels surrounding it. Thyroid cancer

is microscopically small and can spread, unseen, then grow, in a more

distant location; papillary usually spreads via the lymph, as opposed to

vascular, system, while follicular, if I remember correctly, spreads

vascularly. I do know that the presence of vascular invasion is one of

the diagnostic factors in determining whether a follicular irregularity is

benign or malignant.

I hope this helps; I will do some research and hopefully find citations

answering precisely what you're asking.

-

(obviously not a doctor :-)

NYC

anitahin2002 wrote:

> 18691 Angio/Vascular Invasion

>

> , could you or someone on the list know where I could go to find

> answers to my post above? I've searched several places on the web and

> still am unclear as to what these terms mean according to my

> pathology report.

>

> All help appreciated.

>

> Anita in TX

>

[Guest guest]

Angio invasion = vascular invasion,

it mans, as it sounds, that portions of the tumor

are present inside of an artery or vein.

--

############################

ARTURO R. ROLLA, MD

arolla@...

arolla@...

arolla@...

############################

> Dear Anita,

>

> I apologize for ignoring your questions.

>

> Actually, I have your letter highlighted in my inbox; I was hoping

> someone else would write in with the answers, since I wanted to do some

> research first.

> I don't have any official resources for it at the tip of my fingers, so I

> will tell you what I know (or think I know), and get back to you after I've

> had a chance to dig through my files.

>

> I'll start with the easier ones first.

> - " ....there was some parathyroid gland present in the left lobe. The

> surgeon apparently didn't see that she

> had taken some of the parathyroid gland. "

> I'm not sure if this is actually a question or not, but it is not uncommon

> to lose a parathyroid or two during thyroidectomy surgery, and that's

> generally not a problem. We have four of them, and they're apparently

> small and tricky little things, easy to miss and sometimes difficult to

> save. My surgeon agreed with my analogy that the parathyroids are like

> yellow jello pearls in an orange jello thyroid. Often a surgeon can

> replant a parathyroid into a nearby muscle. Most of us can function

> quite well with only two or three, often even one. (you can read more

> about parathyroids at http://www.endocrineweb.com/parathyroid.html)

>

> - ' " ... around the periphery of the nodule, vascular invasion by tumor is

> present'. This is describing the left lobe that had the larger papillary

> tumor. It was stated to be " thinly encapsulated " .

> Thinly encapsulated is not bad. Better than capsular invasion, not quite as

> secure as well encapsulated. Tumors that have invaded the capsular wall

> tend to have a higher incidence of recurrence, although by most standards,

> even recurrence, if it remains localized (within the neck), does not affect

> ultimate mortality rate.

>

> - " The other statement is in the diagnosis of the left lobe " papillary

> carcinoma, follicular variant, with angioinvasion " . "

>

> I don't recall hearing the phrase " angioinvasion " , but I think it is the

> same as " vascular invasion " , meaning that evidence of thyca cells have been

> seen in the blood vessels. This goes back to Amy's question, " can a tumor

> that is encapsulated in the thyroid spread to your lymph nodes without

> first spreading to your thyroid? "

>

> What I would have answered (but hoped someone else would, with total

> certainty or documentation) is yes, I'm rather certain that there can be

> spread outside the thyroid without having evidence of spread within the

> thyroid gland. I've never seen this addressed directly, but my assumption

> is that the more thinly encapsulated the tumor is, the more likely this is.

>

> As for Amy's second question,

> > Does everyone who has spread to the lymph nodes have " VASCULAR invasion " ?

>

> > Or does that mean something different?

>

> Again, my understanding is that absolutely, if there is thyca malignancy

> outside of the gland, it constitutes " vascular invasion " . It does not,

> however, necessarily mean that the cancer will be seen outside the tumor

> within the gland, or even in the vessels surrounding it. Thyroid cancer

> is microscopically small and can spread, unseen, then grow, in a more

> distant location; papillary usually spreads via the lymph, as opposed to

> vascular, system, while follicular, if I remember correctly, spreads

> vascularly. I do know that the presence of vascular invasion is one of

> the diagnostic factors in determining whether a follicular irregularity is

> benign or malignant.

>

> I hope this helps; I will do some research and hopefully find citations

> answering precisely what you're asking.

>

> -

> (obviously not a doctor :-)

> NYC

>

> anitahin2002 wrote:

>

> > 18691 Angio/Vascular Invasion

> >

> > , could you or someone on the list know where I could go to find

> > answers to my post above? I've searched several places on the web and

> > still am unclear as to what these terms mean according to my

> > pathology report.

> >

> > All help appreciated.

> >

> > Anita in TX

> >

>

>

>