expert type icon EXPERT

Dr. Lester D. r. Thompson, M.D.

Pathologist

With more than 25 years of experience in Head and Neck and Endocrine Pathology, Dr. Lester D.R. Thompson worked for a decade at the Armed Forces Institute of Pathology (Washington,
DC), continuing as a consultant and research pathologist in the ensuing years for the Southern California Permanente Medical Group in Los Angeles county. He is a retired Navy Captain, with
20 years of service. He has maintained a prodigious research effort (over 240 papers*); serves on the editorial boards of many peer reviewed scientific journals; teaches at national and
international conferences; serves as an active member of a number of national and international societies (including former President of the North American Society of Head and Neck Pathology); is an active member of the College of American Pathologists Protocol Committee (among others); and collaborated on the two most recent editions (2003; 2016) of the World Health Organization’s
classifications for Head and Neck Tumors and Endocrine Organ Tumors. He is the chair of the ICCR head and neck dataset group. He has published 8 books, considered excellent texts in the
field, and will be a contributing co-editor on the new edition of the AFIP Salivary Gland Tumor Fascicle. He is on the standing committee for the World Health Organization Tumor Classification Series.
31 years Experience
Dr. Lester D. r. Thompson, M.D.
  • Woodland Hills, CA
  • Loma Linda University Medical School
  • Accepting new patients

What areas of the prostate are used during a biopsy?

Most urologists take 12 biopsies, six from each side (lobe) of the prostate gland, and they take them from the apex, mid and base regions. This allows for a very good sampling READ MORE
Most urologists take 12 biopsies, six from each side (lobe) of the prostate gland, and they take them from the apex, mid and base regions. This allows for a very good sampling and evaluation of the whole prostate gland, although most cancers tend to be found in the posterior basal region, rather than the apex. The biopsies are taken with a really thin needle, and evaluated by pathologists who will give an interpretation of whether cancer is there or not.

Forensic pathologist vs pathologist

Taking additional training in the field of forensics, and taking a board examination in this area for board certification. It is usually a 1 year fellowship, although it can be READ MORE
Taking additional training in the field of forensics, and taking a board examination in this area for board certification. It is usually a 1 year fellowship, although it can be longer depending on your area of specialization.

Why do they send a mole biopsy sample for second opinion?

Depending on your age, the site of the body affected, and what the clinical findings were, there are times when the pathology may not be straight forward, and thus an expert on READ MORE
Depending on your age, the site of the body affected, and what the clinical findings were, there are times when the pathology may not be straight forward, and thus an expert on consultation opinion would be sought to try and resolve the question. It does not mean it is malignant or a cancer, but it is better to be safe than sorry.

I have single lymph node enlargement. Is this due to cancer?

Lymph nodes are the sieves of the body, reacting to things that are foreign or should not be there. Your body reacts to things all of the time, and thus lymph nodes enlarge and READ MORE
Lymph nodes are the sieves of the body, reacting to things that are foreign or should not be there. Your body reacts to things all of the time, and thus lymph nodes enlarge and reduce in size all of the time. If it is a persistent enlargement, then there may be something more serious going on. One lymph node enlarged can be seen in many different disorders. Depending on your age, the lymph node size, clinical symptoms and duration of these findings, additional tests, such as a fine needle aspiration of the lymph node (a small biopsy of the lymph node), cultures, blood tests and other imaging tests can all be done to more fully evaluate what is going on.

Is pathology of pleomorphic adenoma accurate?

FNA is a very good screening technique, and the findings for a pleomorphic adenoma are usually quite unique and specific. Importantly, though it is a screening test, and this is READ MORE
FNA is a very good screening technique, and the findings for a pleomorphic adenoma are usually quite unique and specific. Importantly, though it is a screening test, and this is why it is a guide to having surgery. Depending on your age, how long you have had symptoms, what the tumor looks like on imaging findings and the overall size, there is a low, but still possible, risk that cancer may be found within the pleomorphic adenoma (<10% chance). But, pleomorphic adenoma is the most common salivary gland tumor (80% of all tumors), and so it is usually not a high chance there is anything else present.

Breast cancer biopsy

This is not a valid question, as a needle core biopsy and a core sample is equivalent. These are very accurate in finding cancers. However, margins, lymphovascular invasion (vessel READ MORE
This is not a valid question, as a needle core biopsy and a core sample is equivalent. These are very accurate in finding cancers. However, margins, lymphovascular invasion (vessel involvement) and other findings cannot be assessed well with this technique. But, core biopsies are performed to guide the next steps in management, deciding if a lumpectomy, radiation, chemotherapy or other management options should be pursued further. The core can have prognostic markers performed on it to determine the type of post-surgery management (estrogen, progesterone and Her-2/neu).

What is the Gleason score in my pathology report?

Gleason scores are calculated based on the pattern of tumor growth when looked at under the microscope, along with which particular pattern is the most prevalent. The first number READ MORE
Gleason scores are calculated based on the pattern of tumor growth when looked at under the microscope, along with which particular pattern is the most prevalent. The first number is the most prevalent pattern and the second number is the most common. The patterns are graded from 1-5, and since you have 2 patterns scored, you add them together to get a total score. Thus, while a score of 7 sounds the same, a 3+4=7 versus a 4+3=7 is not equivalent. A 4+3=7 is a worse score, since this means that the most prevalent pattern is a higher pattern.

Prostate pathology report

High grade prostatic intraepithelial neoplasia is a precursor lesion that is very strong associated with the later development of, or concurent finding of prostatic adenocarcinoma READ MORE
High grade prostatic intraepithelial neoplasia is a precursor lesion that is very strong associated with the later development of, or concurent finding of prostatic adenocarcinoma (prostate cancer). It does not represent cancer itself, but is a early or pre-cancer. With time, this finding is often associated with or develops into cancer. They are graded into low, intermediate and high grade, and it is only the High grade PIN that is usually associated with cancer.

My mother's biopsy confirmed a malignant tumor. Should we consider a second opinion before the treatment?

It is always a good idea to confirm a malignant diagnosis. The biopsies of the lung are based on a core needle sample, which is <0.1 cm in width. Thus, there are potential over- READ MORE
It is always a good idea to confirm a malignant diagnosis. The biopsies of the lung are based on a core needle sample, which is <0.1 cm in width. Thus, there are potential over- or under-interpretation problems. Depending on the tumor type, it is critical to confirm, as targeted molecular treatments (especially in non-smoking patients) can be of great benefit. It is most important to exclude a metastatic tumor, or tumor that has started in another order and traveled to the lung.

How long does it take for a biopsy report to come?

Usually <48 hours, since you can do the initial evaluation and special studies in that time frame. However, if there is molecular testing, that can add 10-14 additional days after READ MORE
Usually <48 hours, since you can do the initial evaluation and special studies in that time frame. However, if there is molecular testing, that can add 10-14 additional days after the initial interpretation or report.