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Comments (Neuroblastoma)
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Comments (Neuroblastoma)
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Response Options to "Histologic Type"
___ Neuroblastoma
___ Ganglioneuroblastoma
___ Nodular subtype# (specify number of nodules: _____)
___ Intermixed subtype
___ Ganglioneuroma
___ Indeterminate
___ Cannot be assessed
# Note: For nodular (composite) ganglioneuroblastomas with more than 1 nodule, degree of differentiation and mitotic-karyorrhectic index (MKI) must be given for each nodule. Please indicate the differentiation and MKI for the least favorable nodule in the synoptic report. Classification of additional nodules can be described in a comment.
Response Options to "Degree of differentiation"
___ Undifferentiated
___ Poorly differentiated
___ Differentiating
___ Cannot be assessed
___ Not applicable
Response Options to "Mitotic-karyorrhectic index"
___ Low (<100 per 5000 cells; <2%)
___ Intermediate (100-200 per 5000 cells; 2%-4%)
___ High (>200 per 5000 cells; >4%)
___ Indeterminate
___ Cannot be assessed
___ Not applicable
International Neuroblastoma Pathology Classification (INPC) (select all that apply)
Note: INPC applies to untreated primary tumors and tumors in metastatic sites provided that there is sufficient material to classify histologically. Bone marrow biopsy is useful only for evaluation of degree of neuroblastic differentiation, but not eligible for MKI determination.
___ Favorable Histopathology
___ Any age; ganglioneuroma (Schwannian stroma-dominant); maturing or mature
___ Any age; ganglioneuroblastoma, intermixed (Schwannian stroma-rich)
___ Less than 18 months old; neuroblastoma (Schwannian stroma-poor) or nodular
ganglioneuroblastoma; poorly differentiated or differentiating subtypes with low or
intermediate mitosis-karyorrhexis index (MKI)
___ 18 months up to less than 5 years old; neuroblastoma (Schwannian
stroma-poor) or nodular ganglioneuroblastoma; differentiating subtype and low MKI
___ Unfavorable Histopathology
___ Any age; neuroblastoma (Schwannian stroma-poor) or nodular
ganglioneuroblastoma with undifferentiated histology and any MKI
___ Less than 18 months old; neuroblastoma (Schwannian stroma-poor) or nodular
ganglioneuroblastoma with poorly differentiated or differentiating subtypes with
high MKI
___ 18 months up to less than 5 years old; neuroblastoma (Schwannian
stroma-poor) or nodular ganglioneuroblastoma; poorly differentiated and any
MKI, or differentiating and intermediate or high MKI
___ Equal to or greater than 5 years old; neuroblastoma (Schwannian
stroma-poor) or nodular ganglioneuroblastoma; any subtype and any MKI
___ Not applicable secondary to previous chemotherapy
___ Cannot be determined secondary to insufficient material
___ Indeterminate
Response Options to "Extent of primary tumor"
___ Cannot be assessed
___ Encapsulated
___ Extracapsular extension without adjacent organ involvement
___ Extension into adjacent organs
___ Extension into spinal canal