Reading the pathology report (2023)

A pathology report is a medical document written by a pathologist. A pathologist is a doctor who diagnoses a disease by:

  • Explanation of laboratory tests.

  • Assessment of cells, tissues and organs.

In the report, the diagnosis is based on examination by a pathologist of a tissue sample taken from the patient's tumor. This tissue sample, called a sample, is removed during a biopsy. Learn aboutdifferent types of biopsies.

By looking at and analyzing cancerous tissue, a pathologist can discover:

  • Whether the tissue is cancerous or non-cancerous. A cancerous tumor is malignant, which means it can grow and spread to other parts of the body. A non-cancerous or benign tumor means that the tumor can grow but cannot spread.

  • Other details about the characteristics of the tumor. This information will help your doctor choose the best treatment options.

Your doctor will receive the results of these tests as soon as they are available. It may take several days to several weeks to receive a full report. Time depends on the necessary tests. The law allows you to receive a copy of the pathology report. However, it is to be expected that the report will contain highly technical medical terms. Ask your doctor to explain the pathology report results and what they mean.

Parts of the pathology report.

Different pathologists use different words to describe the same things. However, most pathology reports contain the sections discussed below.

Patient, doctor and sample.

This section lists the following items:

rude or obvious description

This section describes a tissue or tumor sample as seen by the naked eye. This includes overall color, weight, size, and texture.

opis mikroskopowy

This is the most technical part of the report. Describe what cancer cells look like when viewed under a microscope. This section lists several factors that influence diagnosis and treatment.

If the cancer is invasive.Many types of tumors can be non-invasive (in situ, meaning "in place") or invasive. Invasive cancers can spread to other parts of the body in a process called metastasis. Although non-invasive cancers do not spread, they may grow in size or become invasive cancers in the future. With invasive cancers, it is important for the pathologist to check how far the tumor has grown into nearby healthy tissue.

Qualification.The grade describes the appearance of cancer cells compared to healthy cells. Generally, the pathologist looks for differences in the size, shape, and staining characteristics of the cells. A tumor containing cells that more closely resemble healthy cells is called "low-grade" or "well-differentiated." A tumor containing cells that are less similar to healthy cells is called "high grade", "poorly differentiated" or "undifferentiated". In general, the lower the stage of the tumor, the better the prognosis. Different methods are used to assign tumor staging to different types of cancer. learn more aboutClassification for particular types of cancer..

How fast cells divide, rate of mitosis.The pathologist usually checks how many cells are dividing. This is called the mitotic rate. Tumors with fewer dividing cells tend to be of low grade.

Tumor margin.Another important factor is whether there are cancer cells at the edges of the biopsy sample. A "positive" or "occupied" margin means there are cancer cells at the margin. This means that cancer cells may still be in the body.

Lymph nodes.The pathologist will also check to see if the cancer has spread to nearby lymph nodes or other organs. Lymph nodes are tiny bean-shaped organs that help fight disease. A lymph node is called "positive" if it contains cancer and "negative" if it does not. A tumor that has outgrown blood or lymph vessels is more likely to have spread to other sites. If the pathologist notices it, he'll include it in the report.

Scenery.Generally, the pathologist assigns the stage using the TNM z systemAmerican Joint Committee on Cancer (AJCC). This system uses 3 factors:

  • Tumor size and location (tumor, T)

  • Have the cancer cells spread to lymph nodes near the tumor (node, N)

  • Whether the tumor has spread to other parts of the body (metastasis, M).

The pathological stage, together with the results of other diagnostic tests, allows to determine the clinical stage of the cancer. This information determines a person's treatment options. Find out more aboutcancer stages.

Other test results.The pathologist can perform special tests to identify specific genes, proteins, and other factors specific to the cancer. The results of these studies may be listed in a separate section or in a separate report. These additional tests are especially important for diagnosis because these results may determine the best treatment option.


This section presents the "conclusion". You'll find this section at the beginning or end of the report. If you have been diagnosed with cancer, this section may contain the following information:

  • A type of cancer, such as carcinoma or sarcoma.

  • The degree of the tumor

  • The condition of the lymph nodes

  • margin state

  • Scenery

  • Any other test results, such as whether the tumor has hormone or other receptorsTumor markers

Synoptic report or summary

After the tumor is removed, the pathologist will attach a summary. It lists the most important results in the table. These are the elements considered most important in determining a person's treatment options and chances of recovery.

comments section

Sometimes cancer can be difficult to diagnose or its development is unclear. In these situations, the pathologist can use the comments section. Here, he can clarify the problems and recommend other tests. This section may also contain other information that may help your doctor plan your treatment.

sampling differences

Occasionally, the biopsy pathology report may differ from the subsequent whole tumor report. This is because the characteristics of a tumor can sometimes differ in different areas. The doctor will consider all reports to develop a treatment plan tailored to the individual patient.

Questions to ask your medical team

To better understand the meaning of the pathology report, consider asking your medical team the following questions:

  • What type of cancer do I have and where did it start?

  • How big is the tumor?

  • Is the cancer invasive or non-invasive?

  • How fast do cancer cells grow?

  • What is the stage of the cancer? What does it mean?

  • Has all the tumor been removed? Are there signs of cancer cells at the edges of the sample?

  • Are there cancer cells in the lymphatic or blood vessels?

  • What is the stage of the cancer? What does it mean?

  • Does the pathology report clearly state the characteristics of the tumor? Should we consult another pathologist?

  • Is it necessary to repeat the test on a different sample or in a different laboratory?

Get a second opinion

It may be helpful to talk to more than one doctor about your diagnosis and treatment plan. This is called a second opinion. It is important to obtain a copy of the pathology report and any other medical records.

If you decide to get a second opinion, you'll want to share it with your second doctor. Some doctors work closely with their pathologists and may also want to hear the views of their pathologists. Other tests may also be performed on the biopsy sample if needed. The tissue sample is stored for a long time and is available upon request. learn more aboutget a second opinion.

Related Resources

Focus on: pathologists

After the biopsy: making a diagnosis

When the doctor says cancer

More information

College of American Pathologists: How to Read a Pathology Report

National Cancer Institute: Pathology Reports


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