2020-03-16
Tumor Synoptic Report: Colorectum / Colectomy
 (View Note) For segmental or total colectomy specimen with carcinoa.
Not for GIST, lymphoma or neuroendocrine tumors
 (Useful tips here ... before you start) -- Select item from a dropdown list, or click on checkbox.
-- Skip undesired items (they'll be removed from final report).
-- Point mouse at "View Note" to reveal more information.

Specimen and Surgical Procedure
Specimen Type:
 (View Note) -- Check all that apply by clicking the leading box(es).
Surgical Procedure:
 (View Note) Select from the dropdown list.    If the desired item is not listed, select "Other (specify)",   then manually type it in "Specify Other" field.
(specify other)
Status of Mesorectum:
 (View Note) Incomplete (grade 1):
little bulk to the mesorectum, defects in the mesorectum down to the muscularis propria, after transverse sectioning the circumferential margin appears very irregular.
Nearly complete (grade 2):
moderate bulk to the mesorectum, irregularity of the mesorectal surface with defects greater than 5 mm but none extending to the muscularis propria, the muscularis propria not exposed except at the insertion site of the levator ani muscles. •
Complete (grade 3):
Intact bulky mesorectum with a smooth surface, only minor irregularities of the mesorectal surface, no surface defects greater than 5 mm in depth, no coning towards the distal margin of the specimen, after circumferential sectioning the circumferential margin appears smooth.
             
Gross Tumor Perforation:
 (View Note) Incomplete (grade 1):
little bulk to the mesorectum, defects in the mesorectum down to the muscularis propria, after transverse sectioning the circumferential margin appears very irregular.
Nearly complete (grade 2):
moderate bulk to the mesorectum, irregularity of the mesorectal surface with defects greater than 5 mm but none extending to the muscularis propria, the muscularis propria not exposed except at the insertion site of the levator ani muscles. •
Complete (grade 3):
Intact bulky mesorectum with a smooth surface, only minor irregularities of the mesorectal surface, no surface defects greater than 5 mm in depth, no coning towards the distal margin of the specimen, after circumferential sectioning the circumferential margin appears smooth.
             

Histologic Characteristics
Histologic Type: (if other)
Tumor Grade:
Other Tumor Component:
 (View Note) -- Skip, if not applicable, to remove it from the final report.
             
Other Component(%): %
Tumor Site:
 (View Note) -- Check all that apply by clicking the leading box(es).
Tumor Size:
 (View Note) -- Manually type in. Numbers entered will become a dropdown list for selection in the future.
cm
Tumor Extension:
Perineural Invasion:              
Angiolymphatic Invasion:
Tumor Budding:
 (View Note) Tumor bud definition: detached clusters of 1 - 5 tumor cells lacking gland lumen formation at the advancing edge of the tumor.
Budding field: filed at 20x (= 0.765 sq mm)
Reference:
Prall F.: Review Tumour budding in colorectal carcinoma. Histopathology. 2007 Jan; 50(1):151-62.
Cappellesso R, et al.: Tumor budding as a risk factor for nodal metastasis in pT1 colorectal cancers: a meta-analysis. Hum Pathol. 2017 Jul;65:62-70
Tumor Deposit:              
Treatment Effect:

Resection Margin Status
The Closest Margin:         Distance from Tumor:  cm
Proximal (End) Margin:                          
Distal (End) Margin:                          
Radial Margin:                          
Side Wall Margin:                          
Mesenteric Margin:                          
Deep Margin:                          
Mucosal Margin:                          

Lymph Node (LN) Status 		                       
Number examined:
 (View Note) -- Manually type in. Numbers entered will become a dropdown list for selection in the future.
Number with Viable Tumor:
Size of Largest Metastasis: cm
Extranodal tumor extension:                          
Treatment Effect:                          

Ancillary Studies 		                     
Test Results:
 (View Note) MMR status of the tumor may be assessed either by immunohistochemistry (IHC) that tests loss of a MMR protein or by PCR based assays for microsatellite instability. IHC and MSI testing are complementary as both have a false negative rate of approximately 5–10%.
Tests in Progress:
 (View Note) -- Check all that apply by clicking the leading box(es).
      Tissue Block:

Pathologic Stage (AJCC 2018 ed.)
  Primary Tumor:

  Regional Lymph Node:

  Distant Metastasis:

Comments:

Key References (* denotes fully accessible and/or PDF downloadable on the Web):
1.* Dawson H. et al: A Review of Current Challenges in Colorectal Cancer Reporting. Arch Pathol Lab Med (2019); 143(7):869-882.
2. Knijn N. et al.: Perineural Invasion is a Strong Prognostic Factor in Colorectal Cancer: A Systematic Review. Am J Surg Pathol (2016) 40(1):103-12.
3.* Landau MS. et al.: Tumor budding is associated with an increased risk of lymph node metastasis and poor prognosis in superficial esophageal adenocarcinoma. Modern Pathology (2014) 27: 1578–1589.
4.* Lugli A. et al.: Recommendations for reporting tumor budding in colorectal cancer based on the International Tumor Budding Modern Pathology (2017) 30: 1299–1311,



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