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my pulm. visit.......


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Well, my visit went OK. I think. Gave Dr. T his hug celebrating my 1 year from diagnosis today. He was the Dr. that found everything - after years of meds, etc. with two other Drs. HOWEVER, this time he had the report from my oncologist. Now, mind you, I am a very gullible person. I have never doubted my doctors, tests, etc., even though in the past most every diagnosis was wrong, tests were wrong from the local hospital, etc. I just had blood work last week I had to redo, because they messed up. Dr. T looking over this letter from my onc. said - I see you were diagnosed with a carcinoid tumor. Well, that is very good, if it is right. There are many pathologists who would argue the difference between a carcinoid and adenocarcinoma. WAIT!!! WHERE DID THAT COME FROM??? I have NEVER heard the adeno thing before?! First, diag. squamous cell, then carcinoid. Now the CDW kicks in, my mind is racing, what does he mean, IF THAT IS RIGHT. THEY TOOK MY LUNG OUT AND TESTED THE THING!!! I am trying to remain calm and tell myself that the BIG hospital in PGH. - a cancer treatment center - would know the difference. Don's words keep going through my head - don't borrow trouble. But, there it is. Do I trust my surgeon, the operating hospital, the oncologist. Or, was Dr. T just talking out loud, trying to explain the original diagnosis??? When I had my bronchoscope with him originally, he came to recovery and said the tumor had the characteristics of a carcinoid tumor - I didn't know what that was then - nor did it matter when the diagnosis came back squamous. Sorry to be so long, I just kind of freaked out. I guess I have since calmed down, but don't really know what to think.

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That would freak me out too!

Because I am a control freak and I have to know everything, I always ask for copies of the reports regardless. I need to read it for myself and then I file it. My health file is amazingly HUGE :!:

Last year I had a Colonoscopy and I have a ulcer in the terminal ileum. They took me in a room and told me the doctor wanted to talk with us (me and my husband). He told me he thought I had Crohn’s disease and wrote me a prescription to treat it. He said start right away on the drug and I'll call you after I get the pathology report. He called me back and said that I don't have it and I still don’t have an answer to what it is. I requested my records and they faxed me my whole chart 34 pages. I even got to read about his initial impression of me. "Forty-one year old female, slightly overweight and pleasant." Boy did that get me laughing!!! :lol::lol::lol:

My point is it's YOUR health that is the topic of these tests and reports your have a right to them. They can also be helpful if you change doctors.

I hope you get this all straightened out so you can put your CWD to rest.


Prayers and Hugs, Shelly

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Pathologists fairly often will disagree. There are a spectrum of neuroendocrine tumors.

1) Typical carcinoid

2) Atypical carcinoid

3) Large cell neuroendocrine carcinoma (LCNEC)


The typical is less agressive than the atypical. which is less agressive then the LCNEC

However, I have heard they may disagree between 1&2 or 2&3 or 3&4.

One way to differentiate the types is by the mitotic rate (how fast the cells divide). SCLS and LCNEC will have a higher mitotic rate than a typical carcinoid. If there is not a whole sample, then it may be harder to determine from a biopsy (this is a guess).

Another thing is that often there are multiple histologies (multiple cancer cell types)

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