Surgical Pathology Cancer Case Summary

URINARY BLADDER, URETER, RENAL PELVIS:             Report

Surgical Pathology Cancer Case Summary

URETER: Resection

MACROSCOPIC (check all that apply)

TUMOR SITE*

___ Right ureter

___ Left ureter

TUMOR SIZE: ___ x ___ x ___ cm*

TUMOR CONFIGURATION*

___ Papillary

___ Solid/nodule

___ Ulcerated

___ Flat

___ Indeterminate

MICROSCOPIC (check all that apply)

HISTOLOGIC TYPE

___ Urothelial (transitional cell) papilloma (WHO/ISUP, 1998; WHO, 1973)

___ Urothelial (transitional cell) papilloma, inverted type

___ Squamous cell papilloma

___ Papillary urothelial (transitional cell) neoplasm, low malignant potential (WHO/ISUP 1998)/ grade I (WHO, 1973)

___ Urothelial (transitional cell) carcinoma in situ

___ Urothelial (transitional cell) carcinoma

___ Urothelial (transitional cell) carcinoma with the following:

___ Squamous differentiation

___ Glandular differentiation

___ Variant histology (specify)

___ Squamous cell carcinoma

___ Typical

___ Variant histology (specify)

___ Adenocarcinoma

___ Typical

___ Variant histology (specify)

___ Small cell carcinoma

___ Undifferentiated carcinoma (specify)

___ Carcinoma, mixed cell type (check all that apply)

___ Urothelial (transitional cell)

___ Squamous cell

___ Adenocarcinoma

___ Small cell carcinoma

___ Other (specify)

HISTOLOGIC GRADE

___ For urothelial carcinoma (WHO/ISUP, 1998)

___ Low grade

___ High grade

___ For adenocarcinoma and squamous carcinoma

___ GX: Cannot be assessed

___ G1: Well differentiated

___ G2: Moderately differentiated

___ G3-4: Poorly differentiated/undifferentiated

EXTENT OF INVASION

___ TX: Cannot be assessed

___ T0: No evidence of primary tumor

___ Ta: Papillary noninvasive papillary carcinoma

___ Tis: Carcinoma in situ

___ T1: Tumor invades subepithelial connective tissue

___ T2: Tumor invades the muscularis

___ T3: Tumor invades beyond muscularis into periureteric fat

___ T4: Tumor invades adjacent organs, or through the kidney into the perinephric fat

MARGINS

___ Margins uninvolved by tumor

Distance of tumor from closest margin: __ cm

(Specify margin (s): ________________)

___ Margin(s) involved by tumor

___ Deep radial periureteral margin (soft tissue)

___ Distal ureteral margin/bladder cuff margin

___ Renal pelvic margin

___ Bladder cuff margin

___ Other(s) (specify: ____________________)

BLOOD/LYMPHATIC VESSEL INVASION

___ Absent

___ Present

___ Indeterminate (see comment)

REGIONAL LYMPH NODES

___ NX: Cannot be assessed

___ N0: No regional lymph node metastasis

Number examined: ___

___ N1: Metastasis in a single lymph node, 2 cm or less in greatest dimension

Number examined: ___

___ N2: Metastasis in a single lymph node, more than 2 cm but not more than 5 cm in greatest dimension, or multiple lymph nodes, none more than 5 cm in greatest dimension

Number examined: ___

Number involved: ___

___ N3: Metastasis in a lymph node more than 5 cm in greatest dimension

Number examined: ___

Total number involved (any size): ___

DISTANT METASTASIS

___ MX: Cannot be assessed

___ M0: No distant metastasis

___ M1: Distant metastasis (site(s):_________

_____________________________________)

ADDITIONAL PATHOLOGIC FINDINGS*

___ Urothelial dysplasia (low grade intraurothelial neoplasia)

___ Focal

___ Multifocal

___ Inflammation/regenerative changes

___ Therapy related changes

___ Cystitis cystica glandularis

___ Keratinizing squamous metaplasia

___ Intestinal metaplasia

___ Other (specify):

COMMENT

___________________________________________

___________________________________________

___________________________________________

___________________________________________