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Anus and perianal area

Miscellaneous

Features to report for tumors


Reviewer: Nat Pernick, M.D. (see Reviewers page)
Revised: 15 April 2013, last major update April 2005
Copyright: (c) 2003-2013, PathologyOutlines.com, Inc.

General
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● Mandatory / optional are for accreditation purposes by the American College of Surgeons Committee on Cancer

Polypectomy (excisional biopsy) - applies to all invasive carcinomas
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Mandatory
● Polyp size: at least one dimension
● Histologic type: squamous cell carcinoma, adenocarcinoma, mucinous adenocarcinoma, small cell carcinoma, undifferentiated carcinoma, other, carcinoma-cannot determine
● Histologic grade: well, moderate or poorly differentiated, undifferentiated, cannot determine or not applicable; for adenocarcinoma, is based on % of tumor that forms glands: well - >95%, moderate - 50-95%, poor - 5-49%, undifferentiated - < 5%
● Depth/extent of invasion: no invasion, cannot determine, into lamina propria, into muscularis mucosa, into submucosa
● Resection margin: cannot assess, positive / negative for invasive carcinoma; if negative, closest tumor to mucosal margin is __ mm, carcinoma in situ absent / present at mucosal margin
● Angiolymphatic invasion: absent, present for large / small vessels, indeterminate

Recommended if known but not required for accreditation purposes
● HPV status
● Tumor site
● Polyp configuration: pedunculated, sessile, unknown
● Additional findings: none, colitis, other

Local excision (transanal disk excision) - applies to all invasive carcinomas
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Mandatory
● Specimen type: intact, fragmented, other
● Tumor size: at least one dimension
● Histologic type: squamous cell carcinoma, adenocarcinoma, mucinous adenocarcinoma, small cell carcinoma, undifferentiated carcinoma, Pagetís disease, other, carcinoma-cannot determine
● Histologic grade: well, moderate or poorly differentiated, undifferentiated, cannot determine or not applicable; for adenocarcinoma, is based on % of tumor that forms glands: well - >95%, moderate - 50-95%, poor - 5-49%, undifferentiated - < 5%
● Depth/extent of invasion: no invasion, cannot determine, into lamina propria, into muscularis mucosa, into submucosa
● For each resection margin: cannot assess, positive / negative for invasive carcinoma; if negative, closest tumor is __ mm from margin, carcinoma in situ absent / present at margin
● Angiolymphatic invasion: absent, present for large / small vessels, indeterminate
● pTNM and stage

Recommended if known but not required for accreditation purposes
● HPV status
● Tumor site
● Tumor configuration: polypoid, infiltrative, ulcerating, other
● Perineural invasion: absent, present
● Additional findings: none, Crohnís disease, condyloma, dysplasia, Pagetís disease, other

Anus resection - applies to all invasive carcinomas
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Mandatory
● Specimen type: abdominoperineal resection, other, not specified
● Tumor site: anterior wall, anal margin, not specified
● Tumor size: at least one dimension
● Histologic type: squamous cell carcinoma, adenocarcinoma, mucinous adenocarcinoma, small cell carcinoma, undifferentiated carcinoma, Pagetís disease, other, carcinoma-cannot determine
● Histologic grade: well, moderate or poorly differentiated, undifferentiated, cannot determine or not applicable; for adenocarcinoma, is based on % of tumor that forms glands: well - >95%, moderate - 50-95%, poor - 5-49%, undifferentiated - < 5%
● Depth/extent of invasion: no invasion, cannot determine, into lamina propria, into muscularis mucosa, into submucosa, into muscularis propria, into subserosa
● For each resection margin (proximal, distal, radial [soft tissue closest to deepest tumor penetration]): cannot assess, positive / negative for invasive carcinoma; if negative, closest tumor is __ mm from margin, carcinoma in situ absent / present at margin
● Angiolymphatic invasion: absent, present for large / small vessels, indeterminate
● Invasion of other structures
● Nodal involvement (# identified, # involved)
● pTNM and stage

Optional
● HPV status
● Tumor configuration: polypoid, infiltrative, ulcerating, other
● Perineural invasion: absent, present
● Additional findings: none, Crohnís disease, condyloma, dysplasia, Pagetís disease, fistula, active colitis, polyps, other

● Protocol for the examination of specimens from patients with carcinomas of the anus and anal canal (Arch Pathol Lab Med 2000;124:21)

End of Anus and perianal area > Miscellaneous > Features to report for tumors


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