- For hysterectomy specimens with sarcomas of the uterus. Not required for myomectomy specimens.
Specimen and Surgical Procedure
Specimen, procedure....................................................................
Specimen integrity................................................................. intact/opened/morcellated
Lymph nodes submitted and/or identified in the specimen........... yes/no
Tumor
Tumor size.................................................................................. ___ cm
Histologic type.............................................................................
Histologic grade (required only for adenosarcoma)....................... low grade/high grade/with sarcomatous overgrowth
Myometrial invasion (required only for adenosarcoma).................. not identified/present
Depth of invasion: __ mm
Myometrial thickness: __ mm
Percentage of myometrial invasion: ___ % (or estimated less than or greater than or equal to 50% myometrial invasion)
Other tissue/organ involvement.....................................................
Lymphovascular invasion.............................................................. not identified/present
Final Margins
Margin(s) .........................................................uninvolved/involved (specify margin(s):)
Lymph Nodes* (required only if lymph nodes are present in specimen)
Total number of nodes examined: _____
Specify site(s)#: ____________________________
# Note: Information should include location and laterality of lymph nodes examined.
Specify lymph node(s) with tumor #: ____________________________
# Note: Information should include location and laterality of lymph nodes with tumor.
Number of nodes with metastasis (excludes ITCs): _____
Number of nodes with isolated tumor cells (ITCs) (0.2 mm or less): _____
Pathologic stage (AJCC 8th ed.)...................................................pT__N__M__