any vets reading this?

[inneedofgoodideas]

my dog (8yo Lab) has had a lump removed from her paw. the vet has said she doesn't think it has spread, but i would really appreciate some help understanding the lab report, which i also recieved. can any vets break down the following report a bit for me? Thanks so much xx

These sections comprise entirely part of a poorly demarcated,
unencapsulated, infiltrative neoplasm. The neoplastic tissue comprises cavernous spaces and small tortuous, anastomosing, cleft-like channels, both filled with blood and supported by a variably thick collagenous stroma and also solid sheets of neoplastic tissue. The neoplastic cells also form solid structures. The tortuous channels are lined by plump cells with indistinct margins, small amounts of eosinophilic cytoplasm, round, ovoid or pleomorphic nuclei with vesicular chromatin and large magenta nucleolus. Anisocytosis and anisokaryosis are mild to moderate.
Mitotic figures are frequent in some places, 1-3/HPF. There is multifocal necrosis and haemorrhage. The neoplastic tissue extends to the margins in my sections.
DIAGNOSIS: Haemangiosarcoma.
COMMENT: Primary cutaneous/subcutaneous haemangiosarcomas are locally invasive and have high local recurrence potential. However, they seem to be less likely to metastasize than their visceral counterparts. Unfortunately it is difficult to prove whether the skin tumour is a primary site or a metastatic focus of a cardiac or splenic haemangiosarcoma. Is there any evidence of a heart condition or splenic enlargement in this patient?

Not a vet but used to reading these reports. The first part is describing the microscopic appearance of the growth in detail, basically that it's a cancerous growth that is made up of abnormal blood vessels and connective tissues. The cancerous tissue goes up to the edge of the specimen, which could mean that there is some left behind, or that the lab didn't receive the whole lump, just a bit of it. This doesn't mean your vet did a bad job of removing it, but there is often some microscopic spread beyond what you can see during a procedure.
If it started in the skin of the paw, there is a high chance of it coming back at the same place. Alternatively it could have started in the heart or spleen and spread from there, so the report is asking whether there are any signs of problems in the heart or spleen (presumably not as your vet has checked her over).
Hope that helps Good luck with your dog x

Hi vet here,
Agree with above poster - all absolutely correct!
Very likely to return in the same spot if all the lump was sent to the laboratory as there is not a clear border of healthy tissue on the sample sent to the laboratory.
Have they done ultrasound of the spleen and heart to check them for tumours?
Haemangiosarcomas are usually quite aggressive cancers and are found most often in the spleen (in my experience), although I have seen them on the skin only, but you do need a good border of healthy tissue removed as well to ensure they don't come back in the same place.

Thanks both for your answers, they are really helpful.
I think the lump was very near her leg muscles/tendons but they did say they got a lot out and were confident they had got it all. I’m not sure how they tell that and it’s a little worrying what you’ve mentioned about needing a healthy border of tissue. Although the vet did say there was a risk it would return.

@luckykitty13 they have done blood tests which showed it isn’t in her organs - I think they showed the lymph nodes weren’t affected? So they have said this is evidence it hasn’t spread. Would you recommend an ultrasound as well?

Blood tests cannot show you if it has spread unfortunately. If they tested the lymph nodes it would have been with a small needle biopsy called a 'fine needle aspirate' or FNA. Ultrasound of the spleen and heart are needed to see if there are any issues there.
I would be asking them if they sent the whole lump for testing or just a small section of it. That will be very helpful in terms of interpreting the report. If they cut the lump in half and sent a section away, then that explains the lack of border visible on the report. If they sent the whole lump away and there is still no healthy border, then that indicates certainty that tumour cells are still present in her leg where the lump was removed.