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Cite this page: Features to report for colonic carcinoma or other tumors. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/colontumorfeaturestoreport.html. Accessed July 14th, 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)
- Intra or peritumoral lymphocytic response
- Pattern of tumor at periphery (pushing, infiltrative)
- Intactness of mesorectum (incomplete, nearly complete or complete)
- Checklists: Michigan Cancer Consortium
- Additional references: Arch Pathol Lab Med 2009;133:1539
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