Protocol for the Examination of Specimens Malignant Pleural Mesothelioma
MALIGNANT PLEURAL MESOTHELIOMA: Select a single response unless otherwise indicated. Procedure (select all that apply) (Note A) ___ Extrapleural pneumonectomy ___ Extended pleurectomy/ decortication ___ Pleurectomy/decortication ___ Partial pleurectomy ___ Other (specify): ____________________________ ___ Not specified Specimen Laterality ___ Right ___ Left ___ Not specified Tumor Site (select all that apply) ___ Parietal pleura ___ Visceral pleura ___ Diaphragm ___ Other (specify): ____________________________ ___ Not specified + Tumor Size (for localized tumors only) + Greatest dimension (centimeters): ___ cm + Additional dimensions (centimeters): ___ x ___ cm + ___ Cannot be determined (explain): ____________________________ Tumor Focality (Note B) ___ Localized ___ Diffuse ___ Cannot be determined Histologic Type (Note C) ___ Epithelioid mesothelioma ___ Sarcomatoid mesothelioma ___ Biphasic mesothelioma ___ Desmoplastic mesothelioma ___ Other histologic type not listed (specify): ____________________________ Tumor Extension (select all that apply) (Note D) ___ No evidence of primary tumor ___ Tumor limited to parietal pleura without involvement of ipsilateral visceral, mediastinal, or diaphragmatic pleura ___ Tumor limited to parietal pleura with focal involvement of ipsilateral visceral, mediastinal, or diaphragmatic pleura ___ Tumor involves all of the ipsilateral pleural surfaces (including fissure) ___ Tumor involves diaphragmatic muscle ___ Tumor extends into lung parenchyma ___ Tumor involves endothoracic fascia CAP Approved Thorax • Pleural Mesothelioma Mesothelioma 4.0.0.1 + Data elements preceded by this symbol are not required for accreditation purposes. These optional elements may be clinically important but are not yet validated or regularly used in patient management. 4 ___ Tumor extends into mediastinal fat ___ Solitary focus extends into the soft tissues of the chest wall ___ Diffuse or multiple foci extend into soft tissue of chest wall ___ Tumor extends into but not through the pericardium ___ Tumor involves rib(s) ___ Tumor involves mediastinal organ(s) (specify): _________________ ___ Other (specify): ____________________________ ___ Cannot be assessed Margins (Note E) ___ Cannot be assessed ___ Uninvolved by mesothelioma ___ Involved by mesothelioma Specify margin(s): ____________________________ ___ Not applicable Regional Lymph Nodes ___ No lymph nodes submitted or found Lymph Node Examination (required only if lymph nodes are present in the specimen) Number of Lymph Nodes Involved: _____ ___ Number cannot be determined (explain): ______________________ Number of Lymph Nodes Examined: _____ ___ Number cannot be determined (explain): ______________________ Treatment Effect (Note F) ___ No known presurgical therapy ___ Greater than 50% residual viable tumor ___ Less than 50% residual viable tumor ___ Cannot be determined Pathologic Stage Classification (pTNM, AJCC 8th edition) (Note G) Note: Reporting of pT, pN, and (when applicable) pM categories is based on information available to the pathologist at the time the report is issued. Only the applicable T, N, or M category is required for reporting; their definitions need not be included in the report. The categories (with modifiers when applicable) can be listed on 1 line or more than 1 line. TNM Descriptors (required only if applicable) (select all that apply) ___ r (recurrent) ___ y (posttreatment) Primary Tumor (pT) ___ pTX: Primary tumor cannot be assessed ___ pT0: No evidence of primary tumor ___ pT1: Tumor limited to the ipsilateral parietal pleura
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