How to Read Your Lung Cancer Pathology Report

Medically Reviewed by Michal Reid, MD
Written by J. GuanDec 22, 20235 min read
Histopathology Report

A pathology report for lung cancer diagnosis should be as unambiguous as possible. It should contain all the details needed for the primary doctor.

  • To understand your cancer diagnosis and prognosis
  • To plan appropriate treatment decisions together with patients

How to read your lung cancer pathology report?

Biopsy reports or pathology reports vary in layout or format, but they should document significant details such as:

  1. Patient identifiers – name, age, date of biopsy, date of the report
  2. Clinical information – patient symptoms, medical conditions, smoking history, biopsy technique
  3. Gross description – description of the specimen by “naked eye”; source of the specimen, size and count of the specimen or tumor size (and sometimes weight), a portion of specimen used in tests, cancer stage
  4. Microscopic description – details the microscopic observation and other tests conducted requiring microscopic evaluation. This includes any staining and the immunohistochemistry results. A proper description of microscopic morphology is also important in reaching the diagnosis (i.e., lung cancer subtypes).
  5. Diagnosis section (green section in the report example below) – final diagnosis made by a pathologist who is also a medical doctor.
  6. Comment section – included to explain issues and controversies if a case is too subtle to diagnose. Pathologists will refer the difficult cases for additional testing.

Example of Pathology Report

Learn more about lung biopsy here.

Your rights as a patient

The pathology report is usually prepared by one pathologist and reviewed by a multidisciplinary team involving the pathologists, your primary doctors, surgeons, and the diagnostic imaging or radiology team.

As a patient, it is crucial to stay informed about the details of your health. The report may be a highly technical medical document. Some useful tips can help you in discussing your results with your doctor.

  • Bring a family member to the consultation. They may be the caregiver when you are ill and may want to understand your disease
  • Take some time to go through the entire report and note down any queries for your doctor
  • Ask any questions when you have one, including how a test is done, if you are keen to know
  • If it helps you to understand a concept, ask your doctor to draw while explaining
  • When you do not understand a scientific or medical term, request your doctor to explain in lay language
  • Arrange a repeat consultation with your doctor if you have more questions and if your doctor lacks detailed knowledge to explain certain pathologic features

It is important to have a clear understanding of your pathology report to make informed decisions regarding your health care.

There are many factors that affect the planning of diagnostic strategies, including:

  1. The performance of diagnostic tests based on the sensitivity, specificity and reliability: An ideal test is highly sensitive, specific and reliable, effectively reducing both false positive and false negative rates
  2. Whether the test can provide enough tissue for diagnosis and genetic testing
  3. How risky and invasive the procedure is
  4. How quickly and easily the test can be done
  5. Whether additional tests for staging the cancer can be done at the same time to avoid more procedures
  6. The available technology and the expertise of the medical team
  7. Whether the tumor appears active and viable in the chosen biopsy location based on imaging tests

Common terms describing how good a diagnostic test are:
Reliability: consistency of a test; if a test is not reliable, it can sometimes give positive results while producing negative results at other times
Sensitivity: the chance of testing positive in individuals with disease; a test with high sensitivity is unlikely to miss patients with disease (meaning low false-negative rate)
Specificity: the chance of testing negative in individuals without disease; a test with high specificity is unlikely to give positive result if a patient do not have a disease (meaning low false-positive rate)

As a patient, it is crucial to stay informed about any changes in your diagnosis and treatment. Your pathology report and doctors’ advice can provide clarity and guidance. Trust that your health is being taken care of, even though it may feel overwhelming at times. Your healthcare team is there to support and guide you at every step of the process. Remember to prioritize your health and well-being above everything else.

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This article has been medically reviewed and fact-checked to ensure our content is informed by the latest research in cancer, global and nationwide guidelines and clinical practice.

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