Non-Hodgkin's

Surgical Pathology Cancer Case Summary

NON-HODGKIN’S LYMPHOMA: Report

Surgical Pathology Cancer Case Summary

NON-HODGKIN’S LYMPHOMA: Biopsy/Resection

MACROSCOPIC (check all that apply)

SPECIMEN TYPE

__ Lymphadenectomy

__ Other (specify: __________________)

TUMOR SITE:

__ Lymph Node(s)

__ Site unknown

Site:__________________________

__ Other tissue(s) or organ(s)* (see separate organ protocols, if applicable)

Site:__________________________

* non-gastrointestinal site (for primary gastrointestinal lymphoma, see Gastrointestinal Lymphoma protocol)

TUMOR SIZE (Largest single mass)

__ x __ x ___ cm (site:________________)

MICROSCOPIC (check all that apply)

IMMUNOPHENOTYPING

___ Performed (see COMMENT, if pertinent)

___ Not performed

HISTOLOGIC TYPE (Revised European-American Lymphoma [REAL] Classification)

___ B cell lymphoma

___ Subtype cannot be determined

___ Precursor B-lymphoblastic lymphoma/leukemia

___ B-cell chronic lymphocytic leukemia/prolymphocytic leukemia/small lymphocytic lymphoma

___ Mantle cell lymphoma

___ Lymphoplasmacytic/immunocytoma

___ Follicle center lymphoma

___ Follicular Grade I

___ Follicular Grade II

___ Follicular Grade III

___ Diffuse predominantly small cell

___ Extranodal marginal zone B-cell lymphoma (low grade B-cell lymphoma of MALT type)

___ Nodal marginal zone B-cell lymphoma (monocytoid B-cell lymphoma)

___ Splenic marginal zone B-cell lymphoma

___ Hairy cell leukemia

___ Plasmacytoma/plasma cell myeloma

___ Diffuse large B-cell lymphoma

___ Primary mediastinal B-cell lymphoma

___ Burkitt’s lymphoma

___ High grade B-cell lymphoma, Burkitt-like

___ T cell lymphoma

___ Subtype cannot be determined

___ Precursor T-lymphoblastic lymphoma/leukemia

___ T-cell chronic lymphocytic leukemia/prolymphocytic leukemia

___ Large granular lymphocytic leukemia

___ T-cell type

___ NK-cell type

___ Mycosis fungoides / Sézary’s syndrome

___ Peripheral T-cell lymphomas, unspecified

___ Hepatosplenic g-d T-cell lymphoma

___ Angioimmunoblastic T-cell lymphoma

___ Nasal / nasal type T/NK cell (angiocentric) lymphoma

___ Adult T-cell lymphoma/leukemia

___ Anaplastic large cell lymphoma

___ T-cell type

___ Null cell type

EXTENT OF TUMOR

___ Cannot be assessed

___ Stage I

___ Involvement of a single lymph node region

(specify site: _________________________)

___ Localized involvement of a single extralymphatic organ or site

(specify site: _________________________________)

___ Stage II

___ Involvement of two or more lymph node regions on the same side of the diaphragm

___ Localized involvement of a single associated extralymphatic organ or site and its regional lymph nodes with or without other lymph node regions on the same side of the diaphragm

___ Stage III: Involvement of lymph node regions on both sides of the diaphragm

with (check those that apply):

___ Localized involvement of an extralymphatic organ or site present

(specify site: _________________________)

___ Involvement of an extralymphatic organ or site-unknown

___ Involvement of the spleen present

___ Involvement of the spleen-unknown

___ Stage IV: Disseminated (multifocal) involvement of one or more extralymphatic organs (specify site(s): __________________________) with (check those that apply):

___ Associated lymph node involvement present

___ Associated lymph node involvement unknown

___ Distant (nonregional) nodal involvement present

___ Distant (nonregional) nodal involvement unknown

ADDITIONAL PATHOLOGIC FINDINGS

Specify: _____________________________________

_____________________________________________

COMMENT

_____________________________________________