GALLBLADDER: Resection
MACROSCOPIC (check all that apply)
SPECIMEN TYPE
___ Cholecystectomy
___ Cholecystectomy with partial hepatectomy
___ Other (specify): ________________________
TUMOR SITE (check all that apply)
___ Fundus
___ Body
___ Neck
TUMOR SIZE: ___ x ___ x___ cm
ADDITIONAL PATHOLOGIC FINDINGS
___ Cholelithiasis
___ Polyp(s)
___ Other (specify): _________________________
MICROSCOPIC (check all that apply)
HISTOLOGIC TYPE
___ Carcinoma in situ
___ Papillary adenocarcinoma
___ Adenocarcinoma, intestinal type
___ Mucinous adenocarcinoma
___ Adenosquamous carcinoma
___ Small cell carcinoma
___ Other: __________________
HISTOLOGIC GRADE
___ Not applicable
___ GX: Cannot be assessed
___ G1: Well differentiated (>95% gland forming)
___ G2: Moderately differentiated (50-95% gland forming)
___ G3: Poorly differentiated (5-49% gland forming)
___ G4: Undifferentiated (<5% gland forming)
EXTENT OF INVASION
___ TX: Cannot be assessed
___ T0: No evidence of primary tumor
___ Tis: Carcinoma in situ
___ T1: Tumor invades lamina propria or muscle layer
___ T1a: Tumor invades lamina propria
___ T1b: Tumor invades muscle layer
___ T2: Tumor invades perimuscular connective tissue; no extension beyond serosa or into liver
___ T3: Tumor perforates serosa (visceral peritoneum) or directly invades into one adjacent organ, or both (extension ≤ 2cm into liver)
___ T4: Tumor extends > 2 cm into liver, and/or into two or more adjacent organs (stomach, duodenum, colon, pancreas, omentum, extrahepatic bile ducts, any involvement of liver)
MARGINS
___ Not peritonealized surface (liver bed)
___ Cystic duct margin
___ Other (specify:__________________)
BLOOD/LYMPHATIC VESSEL INVASION
___ Absent
___ Present
___ Indeterminate
PERINEURAL INVASION
___ Absent
___ Present
___ Indeterminate
REGIONAL LYMPH NODES
___ NX: Cannot be assessed
___ N0: No regional lymph node metastasis
Number examined: ___
___ N1: Metastasis in cystic duct, pericholedochal, and/or hilar lymph nodes (i.e., in the hepatoduodenal ligament)
___ N2: Metastasis in peripancreatic (head only), periduodenal, periportal, celiac, and/or superior mesenteric lymph nodes
DISTANT METASTASIS
___ MX: Cannot be assessed
___ M0: No distant metastasis
___ M1: Distant metastasis (site(s):__________________________________)
ADDITIONAL PATHOLOGIC FINDINGS
___ None identified
___ Dysplasia/adenoma
___ Acute cholecystitis
___ Cholelithiasis
___ Chronic cholecystitis
___ Other (specify: ____________________)
COMMENT
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