Intestine with tumor - Revision history

Mikael Häggström: /* Microscopy report */ Adapted

2022-12-16T23:32:24Z

Microscopy report: Adapted

← Older revision		Revision as of 19:32, 16 December 2022
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	Example:		Example:
	{\|class="wikitable"		{\|class="wikitable"
	\| Colon ~~sample with 50 mm large tubulovillous~~ adenoma with ~~up to~~ high grade ~~columnar epithelial~~ dysplasia. ~~No infiltration.~~ 18 ~~tumor-free~~ lymph nodes~~. Radical excision~~.		\| Colon, segmental colectomy:<br>Tubulovillous adenoma (5.0 cm in greatest dimension) with high-grade dysplasia.<br>18 lymph nodes negative for carcinoma.
	\|}		\|}
	{{CAP}}		{{CAP}}
	{{Reporting}}		{{Reporting}}
	{{Bottom}}		{{Bottom}}

Mikael Häggström: /* Tissue selection */ Contamination

2022-12-13T22:30:48Z

Tissue selection: Contamination

← Older revision		Revision as of 18:30, 13 December 2022
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	[[File:Gross pathology of metastatic melanoma to small intestine.jpg\|thumb\|240px\|For presumable '''metastases''' to the colon (melanoma pictured), one slice from each deposit is enough (or from representative deposits if there are many of them). For presumably primary tumors, generally sample one slice per centimeter of tumor.]]		[[File:Gross pathology of metastatic melanoma to small intestine.jpg\|thumb\|240px\|For presumable '''metastases''' to the colon (melanoma pictured), one slice from each deposit is enough (or from representative deposits if there are many of them). For presumably primary tumors, generally sample one slice per centimeter of tumor.]]
	Should include:<ref name=Stora/>		Should include:<ref name=Stora/>
	*The tumor slices that show the '''deepest penetration'''. The slices should include tumor relation to the serosa or resection margin, as well as adjacent normal mucosa.		*The tumor slices that show the '''deepest penetration'''. The slices should include tumor relation to the serosa or resection margin, as well as adjacent normal mucosa. If transported or processed together with other cases, put the tumor slices in thin-mesh cassettes or tissue bags to limit contamination.<ref group=note>Colorectal adenocarcinoma (the most common colon tumor) is a promiscuous contaminant of other tissues.<br>- {{cite journal\| author=Carll T, Fuja C, Antic T, Lastra R, Pytel P\| title=Tissue Contamination During Transportation of Formalin-Fixed, Paraffin-Embedded Blocks. \| journal=Am J Clin Pathol \| year= 2022 \| volume= 158 \| issue= 1 \| pages= 96-104 \| pmid=35195717 \| doi=10.1093/ajcp/aqac014 \| pmc= \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=35195717 }} </ref>
	*Proximal and distal '''resection margin''', respectively. Take transverse slices except if the tumor is within 2 cm from the margin, in which case it is advisable to take slices perpendicular to that margin, including both the tumor border and the resection margin. [[Ink]] the margins when taking perpendicular sections{{Moderate-begin}}, but this is optional when taking transverse slices.{{Moderate-end}}		*Proximal and distal '''resection margin''', respectively. Take transverse slices except if the tumor is within 2 cm from the margin, in which case it is advisable to take slices perpendicular to that margin, including both the tumor border and the resection margin. [[Ink]] the margins when taking perpendicular sections{{Moderate-begin}}, but this is optional when taking transverse slices.{{Moderate-end}}
	*Take slices of any '''other suspicious''' findings		*Take slices of any '''other suspicious''' findings

Mikael Häggström: /* Gross examination */ Photo

2021-12-20T19:51:47Z

Gross examination: Photo

← Older revision		Revision as of 15:51, 20 December 2021
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	\| Small volume \|\| Up to the muscularis propria \|\| Yes \|\| irregular		\| Small volume \|\| Up to the muscularis propria \|\| Yes \|\| irregular
	\|}		\|}
	*{{Moderate-begin}}Surfaces that appear to overlie a tumor are preferably '''[[inked]]'''.{{Moderate-end}}		*{{Moderate-begin}}Surfaces that appear to overlie a known or suspected tumor are preferably '''[[inked]]''', even for serosal surfaces.{{Moderate-end}} {{Moderate-begin}}Also take a '''photo''' of surfaces overlying a tumor.{{Moderate-end}}
	*Describe the '''serosa''', and whether there are any suspected tumor breakthroughs hereof.<ref name=Stora/>		*Describe the '''serosa''', and whether there are any suspected tumor breakthroughs hereof.<ref name=Stora/>
	*'''Initial intestinal opening''' can be:		*'''Initial intestinal opening''' can be:
	:*A ''longitudinal'' cut opposite to the tumor if it is relatively demarcated (by sight and/or palpation).		:*A ''longitudinal'' cut opposite to the tumor if it is relatively demarcated (by sight and/or palpation).

Mikael Häggström: /* Gross examination */ 150

2021-09-17T16:32:37Z

Gross examination: 150

← Older revision		Revision as of 12:32, 17 September 2021
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	{{Comprehensiveness}}		{{Comprehensiveness}}
	==Gross examination==		==Gross examination==
	[[File:Gross pathology of minimally invasive colorectal surgery of tubulovillous adenoma.jpg\|thumb\|~~200px~~\|There is a separate article for the '''[[Grossing of minimally invasive colorectal surgery]]'''.]]		[[File:Gross pathology of minimally invasive colorectal surgery of tubulovillous adenoma.jpg\|thumb\|150px\|There is a separate article for the '''[[Grossing of minimally invasive colorectal surgery]]'''.]]
	*'''Orientation''': Determine the proximal (oral) and distal (aboral) parts of the specimen if possible.<ref name=Stora>Unless otherwise specified, reference is: {{Stora utskärningen}}</ref>		*'''Orientation''': Determine the proximal (oral) and distal (aboral) parts of the specimen if possible.<ref name=Stora>Unless otherwise specified, reference is: {{Stora utskärningen}}</ref>
	*Measure the '''length''' of the entire specimen.<ref name=Stora/> {{Moderate-begin}}Also measure diameter.{{Moderate-end}}		*Measure the '''length''' of the entire specimen.<ref name=Stora/> {{Moderate-begin}}Also measure diameter.{{Moderate-end}}

Mikael Häggström: /* Gross examination */ Minimally

2021-09-17T16:31:37Z

Gross examination: Minimally

← Older revision		Revision as of 12:31, 17 September 2021
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	{{Comprehensiveness}}		{{Comprehensiveness}}
	==Gross examination==		==Gross examination==
			[[File:Gross pathology of minimally invasive colorectal surgery of tubulovillous adenoma.jpg\|thumb\|200px\|There is a separate article for the '''[[Grossing of minimally invasive colorectal surgery]]'''.]]
	*'''Orientation''': Determine the proximal (oral) and distal (aboral) parts of the specimen if possible.<ref name=Stora>Unless otherwise specified, reference is: {{Stora utskärningen}}</ref>		*'''Orientation''': Determine the proximal (oral) and distal (aboral) parts of the specimen if possible.<ref name=Stora>Unless otherwise specified, reference is: {{Stora utskärningen}}</ref>
	*Measure the '''length''' of the entire specimen.<ref name=Stora/> {{Moderate-begin}}Also measure diameter.{{Moderate-end}}		*Measure the '''length''' of the entire specimen.<ref name=Stora/> {{Moderate-begin}}Also measure diameter.{{Moderate-end}}

Mikael Häggström: /* Tissue selection */ Size

2021-09-17T15:42:40Z

Tissue selection: Size

← Older revision		Revision as of 11:42, 17 September 2021
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	===Tissue selection===		===Tissue selection===
	[[File:Gross pathology of metastatic melanoma to small intestine.jpg\|thumb\|For presumable '''metastases''' to the colon (melanoma pictured), one slice from each deposit is enough (or from representative deposits if there are many of them). For presumably primary tumors, generally sample one slice per centimeter of tumor.]]		[[File:Gross pathology of metastatic melanoma to small intestine.jpg\|thumb\|240px\|For presumable '''metastases''' to the colon (melanoma pictured), one slice from each deposit is enough (or from representative deposits if there are many of them). For presumably primary tumors, generally sample one slice per centimeter of tumor.]]
	Should include:<ref name=Stora/>		Should include:<ref name=Stora/>
	*The tumor slices that show the '''deepest penetration'''. The slices should include tumor relation to the serosa or resection margin, as well as adjacent normal mucosa.		*The tumor slices that show the '''deepest penetration'''. The slices should include tumor relation to the serosa or resection margin, as well as adjacent normal mucosa.

Mikael Häggström: /* Tissue selection */ +Metastasis

2021-09-17T15:42:11Z

Tissue selection: +Metastasis

← Older revision		Revision as of 11:42, 17 September 2021
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	===Tissue selection===		===Tissue selection===
			[[File:Gross pathology of metastatic melanoma to small intestine.jpg\|thumb\|For presumable '''metastases''' to the colon (melanoma pictured), one slice from each deposit is enough (or from representative deposits if there are many of them). For presumably primary tumors, generally sample one slice per centimeter of tumor.]]
	Should include:<ref name=Stora/>		Should include:<ref name=Stora/>
	*The tumor slices that show the '''deepest penetration'''. The slices should include tumor relation to the serosa or resection margin, as well as adjacent normal mucosa.		*The tumor slices that show the '''deepest penetration'''. The slices should include tumor relation to the serosa or resection margin, as well as adjacent normal mucosa.

Mikael Häggström: /* Gross examination */ Gallery

2021-09-17T15:38:15Z

Gross examination: Gallery

← Older revision		Revision as of 11:38, 17 September 2021
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	\|}		\|}
	*{{Moderate-begin}}Surfaces that appear to overlie a tumor are preferably '''[[inked]]'''.{{Moderate-end}}		*{{Moderate-begin}}Surfaces that appear to overlie a tumor are preferably '''[[inked]]'''.{{Moderate-end}}
			*Describe the '''serosa''', and whether there are any suspected tumor breakthroughs hereof.<ref name=Stora/>
	*'''Initial intestinal opening''' can be:		*'''Initial intestinal opening''' can be:
	:*A ''longitudinal'' cut opposite to the tumor if it is relatively demarcated (by sight and/or palpation).		:*A ''longitudinal'' cut opposite to the tumor if it is relatively demarcated (by sight and/or palpation).
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	*Measure the '''distances''' to the proximal and distal surgical margins.<ref name=Stora/>		*Measure the '''distances''' to the proximal and distal surgical margins.<ref name=Stora/>
	*Note any accompanying '''polyps'''.<ref name=Stora/> ''See [[Colorectal polyp]]''		*Note any accompanying '''polyps'''.<ref name=Stora/> ''See [[Colorectal polyp]]''
	[[File:Gross pathology of small intestinal adenocarcinoma, serosal view.jpg\|thumb\|200px\|Gross pathology of small intestine with adenocarcinoma, serosal view, showing cancer with infiltrative growth (in this case an adenocarcinoma), causing stenosis.]]
	~~[[File:Gross pathology of small intestinal adenocarcinoma, luminal view.jpg\|thumb\|200px\|Luminal view, showing the stenotic infiltrative growth across the entire intestinal wall.]]~~
	~~[[File:Edges and margins in intestinal tumor.svg\|thumb\|220px\|Margins that need to be determined.]]~~
	*Describe the '''serosa''', and whether there are any suspected tumor breakthroughs hereof.<ref name=Stora/>
	*Evaluate the following either before or after slicing it up:<ref name=Stora/>		*Evaluate the following either before or after slicing it up:<ref name=Stora/>
	:*Tumor '''size'''		:*Tumor '''size'''
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	*'''Serially section''' the tumor, either by transverse or longitudinal sectioning.<ref name=Stora/>		*'''Serially section''' the tumor, either by transverse or longitudinal sectioning.<ref name=Stora/>
	*Review each slice and note the '''depth''' (in terms of anatomic layer, possibly with rough percentage thereof) and distance to the serosa or transverse resection margin for any tumor invasion and/or infiltration.<ref name=Stora/>		*Review each slice and note the '''depth''' (in terms of anatomic layer, possibly with rough percentage thereof) and distance to the serosa or transverse resection margin for any tumor invasion and/or infiltration.<ref name=Stora/>
			<gallery mode=packed heights=190>
			File:Gross pathology of small intestinal adenocarcinoma, serosal view.jpg\|Gross pathology of small intestine with adenocarcinoma, serosal view, showing cancer with infiltrative growth (in this case an adenocarcinoma), causing stenosis.
			File:Gross pathology of small intestinal adenocarcinoma, luminal view.jpg\|Luminal view, showing the stenotic infiltrative growth across the entire intestinal wall.
			File:Edges and margins in intestinal tumor.svg\|Margins that need to be determined.
			</gallery>
	*Carefully go through included '''mesentery''' for lymph nodes. A consensus standard is to find at least 12 lymph nodes from colon specimens.<ref name="pmid19461921">{{cite journal\| author=Wong SL\| title=Lymph node counts and survival rates after resection for colon and rectal cancer. \| journal=Gastrointest Cancer Res \| year= 2009 \| volume= 3 \| issue= 2 Suppl \| pages= S33-5 \| pmid=19461921 \| doi= \| pmc=2684729 \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19461921 }} </ref> {{Further\|Lymph nodes}}		*Carefully go through included '''mesentery''' for lymph nodes. A consensus standard is to find at least 12 lymph nodes from colon specimens.<ref name="pmid19461921">{{cite journal\| author=Wong SL\| title=Lymph node counts and survival rates after resection for colon and rectal cancer. \| journal=Gastrointest Cancer Res \| year= 2009 \| volume= 3 \| issue= 2 Suppl \| pages= S33-5 \| pmid=19461921 \| doi= \| pmc=2684729 \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19461921 }} </ref> {{Further\|Lymph nodes}}

Mikael Häggström: /* Microscopy report */ CAP

2021-09-09T13:14:25Z

Microscopy report: CAP

← Older revision		Revision as of 09:14, 9 September 2021
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	\| Colon sample with 50 mm large tubulovillous adenoma with up to high grade columnar epithelial dysplasia. No infiltration. 18 tumor-free lymph nodes. Radical excision.		\| Colon sample with 50 mm large tubulovillous adenoma with up to high grade columnar epithelial dysplasia. No infiltration. 18 tumor-free lymph nodes. Radical excision.
	\|}		\|}
			{{CAP}}
	{{Reporting}}		{{Reporting}}
	{{Bottom}}		{{Bottom}}

Mikael Häggström: /* Gross examination */ Linked

2021-03-17T17:33:52Z

Gross examination: Linked

← Older revision		Revision as of 13:33, 17 March 2021
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	*'''Serially section''' the tumor, either by transverse or longitudinal sectioning.<ref name=Stora/>		*'''Serially section''' the tumor, either by transverse or longitudinal sectioning.<ref name=Stora/>
	*Review each slice and note the '''depth''' (in terms of anatomic layer, possibly with rough percentage thereof) and distance to the serosa or transverse resection margin for any tumor invasion and/or infiltration.<ref name=Stora/>		*Review each slice and note the '''depth''' (in terms of anatomic layer, possibly with rough percentage thereof) and distance to the serosa or transverse resection margin for any tumor invasion and/or infiltration.<ref name=Stora/>
	*Carefully go through included '''mesentery''' for lymph nodes~~, and cut each in two parts~~. A consensus standard is to find at least 12 lymph nodes from colon specimens.<ref name="pmid19461921">{{cite journal\| author=Wong SL\| title=Lymph node counts and survival rates after resection for colon and rectal cancer. \| journal=Gastrointest Cancer Res \| year= 2009 \| volume= 3 \| issue= 2 Suppl \| pages= S33-5 \| pmid=19461921 \| doi= \| pmc=2684729 \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19461921 }} </ref>		*Carefully go through included '''mesentery''' for lymph nodes. A consensus standard is to find at least 12 lymph nodes from colon specimens.<ref name="pmid19461921">{{cite journal\| author=Wong SL\| title=Lymph node counts and survival rates after resection for colon and rectal cancer. \| journal=Gastrointest Cancer Res \| year= 2009 \| volume= 3 \| issue= 2 Suppl \| pages= S33-5 \| pmid=19461921 \| doi= \| pmc=2684729 \| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19461921 }} </ref> {{Further\|Lymph nodes}}

	===Tissue selection===		===Tissue selection===