Surgical Pathology Cancer Case Summary
ANUS: Report
Surgical Pathology Cancer Case Summary
MACROSCOPIC (check all that apply)
SPECIMEN TYPE
___ Biopsy
___ Polypectomy
TUMOR SITE
___ Unknown
___ Anterior wall
(Distance from anal verge: ___ cm)
___ Distance from anal verge unknown
___ Posterior wall
(Distance from anal verge: ___ cm)
___ Distance from anal verge unknown
___ Right wall
(Distance from anal verge: ___ cm)
___ Distance from anal verge unknown
___ Left wall
(Distance from anal verge: ___ cm)
___ Distance from anal verge unknown
___ Anal margin
POLYPECTOMY ONLY
Polyp size: ___ x ___ x ___
Polyp configuration:
___ Pedunculated
___ Stalk (stalk length: ___ cm)
___ No stalk
___ Sessile
MICROSCOPIC (check all that apply)
HISTOLOGIC TYPE
___ Squamous cell carcinoma
___ Large cell keratinizing
___ Large cell nonkeratinizing
___ Basaloid
___ Carcinoma in situ (Bowen’s disease)
___ Adenocarcinoma
___ Rectal type
___ Of anal glands
___ Within anorectal fistula
___ Paget’s disease
___ Small cell carcinoma
___ Giant condyloma (verrucous carcinoma)
___ Basal cell carcinoma
___ Undifferentiated carcinoma
___ Other:___________________
HISTOLOGIC GRADE (if applicable to tumor type)
___ Not applicable
___ GX: Cannot be assessed
___ G1: Well differentiated
___ G2: Moderately differentiated
___ G3: Poorly differentiated
___ G4: Undifferentiated
EXTENT OF INVASION
___ Cannot be determined
___ Epithelium only (no invasion)
___ Invasion (deepest)
___ Cannot be determined
___ Into lamina propria
___ Into muscularis mucosae
___ Into submucosa
MARGIN (polypectomy only)
___ Not applicable
___ Uninvolved by tumor
Distance of tumor from margin: ___ cm
___ Involved by tumor
BLOOD/VESSEL INVASION
___ Not applicable
___ Absent
___ Present
___ Indeterminate
ADDITIONAL PATHOLOGIC FINDINGS
___ None identified
___ Active colitis
___ Other (specify: _____________________)
COMMENT
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