Endocrine Pancreas Cancer Protocol



Endocrine Pancreas Cancer Protocol


Laura Webb Lamps, MD










Pancreas (Endocrine): Resection



















































































































































































































































































































































































































































































Surgical Pathology Cancer Case Summary (Checklist)


Specimen



____ Head of pancreas



____ Body of pancreas



____ Tail of pancreas



____ Stomach



____ Common bile duct



____ Gallbladder



____ Spleen



____ Adjacent large vessels




____ Portal vein




____ Superior mesenteric vein



____ Other larger vessel (specify): ______________________________



____ Other (specify): ______________________________



____ Not specified



____ Cannot be determined


Procedure



____ Excisional biopsy (enucleation)



____ Pancreaticoduodenectomy (Whipple resection), partial pancreatectomy



____ Pancreaticoduodenectomy (Whipple resection), total pancreatectomy



____ Partial pancreatectomy, pancreatic tail



____ Other (specify): ______________________________



____ Not specified


Tumor Site (select all that apply)



____ Pancreatic head



____ Uncinate process



____ Pancreatic tail



____ Other (specify): ______________________________



____ Cannot be determined



____ Not specified


Tumor Size



Greatest dimension: __________ cm (specify size of largest tumor if multiple tumors are present)



*Additional dimensions: _________ × __________ cm



____ Cannot be determined


Tumor Focality



____ Unifocal



____ Multifocal (specify number of tumors): ______________________________



____ Cannot be determined



____ Not specified


Histologic Type



____ Well-differentiated endocrine neoplasm



____ Poorly differentiated endocrine carcinoma




*____ Small cell carcinoma




*____ Large cell endocrine carcinoma



____ Other (specify): ______________________________



____ Carcinoma, type cannot be determined


*World Health Organization Classification



*____ Well-differentiated endocrine tumor, benign behavior



*____ Well-differentiated endocrine tumor, uncertain behavior



*____ Poorly differentiated endocrine carcinoma


*Functional Type (select all that apply)



*____ Cannot be assessed



*____ Pancreatic endocrine tumor, functional




(Correlation with clinical syndrome and elevated serum levels of hormone product)





*____ Insulin-producing (insulinoma)





*____ Glucagon-producing (glucagonoma)





*____ Somatostatin-producing (somatostatinoma)





*____ Gastrin-producing (gastrinoma)





*____ Vasoactive intestinal polypeptide (VIP)-producing (VIP-oma)





*____ Other (specify): ______________________________



*____ Pancreatic endocrine tumor, nonfunctional



*____ Pancreatic endocrine tumor, functional status unknown


Mitotic Activity (select all that apply)



____ Not applicable



___ < 2 mitoses/10 high-power fields (HPF)




Specify mitoses per 10 HPF: __________



____ 2-10 mitoses/10 HPF




Specify mitoses per 10 HPF: _________



____ > 10 mitoses per 10 HPF



____ Cannot be determined



*Ki-67 labeling index




*____ ≤ 2% Ki-67-positive cells




*____ 3-20% Ki-67-positive cells




*____ > 20% Ki-67-positive cells


*Tumor Necrosis



*____ Not identified



*____ Present



*____ Not applicable



*____ Cannot be determined


Microscopic Tumor Extension (select all that apply)



____ Cannot be determined



____ No evidence of primary tumor



____ Tumor is confined to pancreas



____ Tumor invades ampulla of Vater



____ Tumor invades common bile duct



____ Tumor invades duodenal wall



____ Tumor invades peripancreatic soft tissues



____ Tumor invades other adjacent organs or structures (specify): ______________________________


Margins (select all that apply)



____ Cannot be assessed



____ Margins uninvolved by tumor




Distance of tumor from closest margin: __________ mm




*Specify margin (if possible): ______________________________



____ Margin(s) involved by tumor




____ Uncinate process (retroperitoneal) margin (nonperitonealized surface of the uncinate process)




____ Distal pancreatic margin




____ Common bile duct margin




____ Proximal pancreatic margin




____ Other (specify): ______________________________



*____ Tumor involves posterior retroperitoneal surface of pancreas


Lymph-Vascular Invasion



____ Not identified



____ Present



____ Indeterminate


Pathologic Staging (pTNM)



TNM descriptors (required only if applicable) (Select all that apply)




____ m (multiple descriptors)




____ r (recurrent)




____ y (post-treatment)



Primary tumor (pT)




____ pTX: Cannot be assessed




____ pT0: No evidence of primary tumor




____ pT1: Tumor limited to pancreas, ≤ 2 cm in greatest dimension




____ pT2: Tumor limited to pancreas, > 2 cm in greatest dimension




____ pT3: Tumor extends beyond pancreas but without involvement of celiac axis or superior mesenteric artery




____ pT4: Tumor involves celiac axis or superior mesenteric artery



Regional lymph nodes (pN)




____ pNX: Cannot be assessed




____ pN0: No regional lymph node metastasis




____ pN1: Regional lymph node metastasis





Specify: Number examined: __________






Number involved: __________



Distant metastasis (pM)




____ Not applicable




____ pM1: Distant metastasis





*Specify site(s), if known: ______________________________


*Additional Pathologic Findings (select all that apply)



*____ None identified



*____ Chronic pancreatitis



*____ Acute pancreatitis



*____ Adenomatosis (multiple endocrine tumors, each < 5 mm in greatest dimension)



*____ Other (specify): ______________________________


*Clinical History (select all that apply)



*____ von Hippel-Lindau disease



*____ Multiple endocrine neoplasia type 1



*____ Familial pancreatic cancer syndrome



*____ Hypoglycemic syndrome



*____ Necrolytic migratory erythema



*____ Watery diarrhea



*____ Hypergastrinemia



*____ Zollinger-Ellison syndrome



*____ Other (specify): ______________________________



*____ Not specified


* Data elements with asterisks are not required. However, these elements may be clinically important but are not yet validated or regularly used in patient management. Adapted with permission from College of American Pathologists, “Protocol for the Examination of Specimens from Patients with Carcinoma of the Endocrine Pancreas.” Web posting date October 2009, www.cap.org.

Only gold members can continue reading. Log In or Register to continue

Jul 7, 2016 | Posted by in PATHOLOGY & LABORATORY MEDICINE | Comments Off on Endocrine Pancreas Cancer Protocol
Premium Wordpress Themes by UFO Themes
%d bloggers like this: