Surgical Pathology Cancer Case Summary

STOMACH:             Report

STOMACH: Cytology/Biopsy

MACROSCOPIC (check all that apply)

SPECIMEN TYPE

___ Cytology

___ Incisional biopsy

___ Excisional biopsy (polypectomy)

TUMOR SITE

___ Cardia

___ Fundus (sublocation below, if known)

___ Unknown

___ Anterior wall

___ Posterior wall

___ Body (sublocation below, if known)

___ Unknown

___ Anterior wall

___ Posterior wall

___ Lesser curvature

___ Greater curvature

___ Antrum (sublocation below, if known)

___ Unknown

___ Anterior wall

___ Posterior wall

___ Lesser curvature

___ Greater curvature

___ Unknown

TUMOR SIZE: ___ cm (excisional biopsy only)

MICROSCOPIC (check all that apply)

HISTOLOGIC TYPE

___ Cannot be determined

___ Adenocarcinoma

___ Papillary adenocarcinoma

___ Tubular adenocarcinoma

___ Mucinous adenocarcinoma (>50% mucinous)

___ Signet ring cell carcinoma (>50% signet ring cells)

___ Other:___________________

HISTOLOGIC GRADE (adenocarcinoma only)

___ 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

___ 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

ADDITIONAL PATHOLOGIC FINDINGS

___ None identified

___ Intestinal metaplasia

___ Dysplasia

___ Gastritis (type: _____________________)

___ Other (specify: _____________________)

COMMENT

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