Surgical Pathology Cancer Case Summary

HEART:             Report

Cytology/Biopsy/Resection

HEART: Cytology/Biopsy/Resection

MACROSCOPIC (check all that apply)

SPECIMEN TYPE

___ Cytology

___ FNA

___ Other (specify: _____________________)

___ Biopsy

___ Incisional

___ Excisional

TUMOR SITE

___ Pericardium

___ Right ventricle

___ Left ventricle

___ Right atrium

___ Left atrium

___ Unknown

TUMOR SIZE, if applicable: ___ (x ___ x ___) cm

MICROSCOPIC (check all that apply)

HISTOLOGIC TYPE

___ Sarcoma

specify subtype: __________________________

___ Lymphoma

specify subtype: __________________________

___ Carcinoma

specify subtype: __________________________

HISTOLOGIC GRADE

___ Cannot be determined

___ Low grade

___ High grade

EXTENT OF INVASION (as appropriate)

___ Cannot be determined

___ No involvement of adjacent tissue(s)

___ Involvement of adjacent tissue(s)

___ Other organ involvement

(specify: _________________________________)

MARGINS, as appropriate

___ Not applicable

___ Uninvolved by tumor

___ Involved by tumor (specify site: _____________)

ADDITIONAL PATHOLOGIC FINDINGS

___ None identified

___ Benign tumor (specify: ____________________)

___ Therapy-related changes (specify:___________)

___ Inflammation

___ Other (specify: _____________________)

COMMENT

___________________________________________

___________________________________________

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