Colon tumor
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Features to report for colonic carcinoma or other tumors

Author: Charanjeet Singh, M.D. (see Authors page)

Revised: 3 January 2017, last major update May 2012

Copyright: (c) 2003-2017, PathologyOutlines.com, Inc.

PubMed search: features [title] colonic carcinoma

Cite this page: Features to report for colonic carcinoma or other tumors. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/colontumorfeaturestoreport.html. Accessed August 17th, 2017.
Definition / general
  • Editorial note
  • Note: "mandatory" means for accreditation purposes by the American College of Surgeons Committee on Cancer
  • "Recommended" means suggested by the literature
  • Protocol may improve quality of pathology report (Colorectal Dis 2011;13:e33)
Diagrams / tables

Images hosted on other servers:

Anatomic subsites

Margins


Staging related diagrams

Colonic biopsy - recommended features to report
  • Biopsy site
  • Tumor size
  • Histologic type
  • Histologic grade (low grade: 50%+ gland formation; otherwise high grade)
  • Depth of invasion (if identifiable)
  • Angiolymphatic invasion (including extramural venous invasion)
Polypectomy - mandatory to report
  • Tumor site
  • Polyp size
  • Polyp configuration (pedunculated with or without stalk, sessile or fragmented)
  • Histologic type
  • Histologic grade (low grade: 50%+ gland formation; otherwise high grade)
  • Depth of invasion
  • Involvement of deep (stalk) margin by invasive carcinoma or distance of invasive carcinoma from margin
  • Involvement of mucosal / lateral margin by invasive or in situ carcinoma
  • Lymphatic invasion
Polypectomy - recommended but not required to report
  • Large vessel invasion
  • Type of polyp in which invasive carcinoma arose
  • Additional findings
Rectal tumor: local excision - mandatory to report
  • Specimen intact or fragmented
  • Tumor size
  • Histologic type
  • Histologic grade (low grade: 50%+ gland formation; otherwise high grade)
  • pT and pN staging
  • Lateral margin involvement by invasive carcinoma or distance to margin
  • Deep margin involvement by invasive carcinoma or distance to margin
  • Focal or multifocal involvement of deep margin by invasive carcinoma
  • Lymphatic invasion
  • Large vessel invasion
Rectal tumor: local excision - recommended but not required to report
  • Distance of tumor from anal verge
  • Lateral margin involvement by adenoma
  • Perineural invasion
  • Dysplasia present (high grade, low grade)
  • Depth of invasion (part of staging)
  • Additional findings
Colorectal resection for tumor - mandatory to report
  • Specimen type
  • Tumor site
  • Tumor size
  • Macroscopic tumor perforation (present or not)
  • Histologic type
  • Histologic grade (low grade: 50%+ gland formation; otherwise high grade)
  • pT, pN and pM staging
  • Proximal margin involvement by invasive carcinoma or adenoma or distance to margin
  • Distal margin involvement by invasive carcinoma or adenoma or distance to margin
  • Radial margin involvement by invasive carcinoma or adenoma or distance to margin
  • If all margins are negative, specify closest margin and distance of invasive carcinoma from this margin
  • Lymphatic invasion
  • Large vessel invasion
  • Features suggestive of microsatellite instability (intratumoral lymphocytes, peritumoral lymphocytes, mucinous / medullary / poorly differentiated)
  • Treatment effect (if relevant)
  • Tumor deposits (discontinuous extramural extension)
  • Ancillary studies performed (microsatellite instability, immunohistochemistry, mutational analysis)
Colorectal resection for tumor - recommended but not required to report
  • Specimen length
  • Macroscopic intactness of mesorectum
  • Gross tumor configuration (exophytic, infiltrative, ulcerative or other)
  • Peritoneal (mesenteric) margin involvement by invasive carcinoma or adenoma or distance to margin
  • Perineural invasion
  • Depth of invasion (part of staging)
  • Additional findings
Possible features to report (suggested by some authors)