Protocol for the Examination of Gist Specimens



Protocol for the Examination of Gist Specimens





























































































































































































































Gastrointestinal Stromal Tumor (GIST): Biopsy


Surgical Pathology Cancer Case Summary (Checklist)


Procedure



____Core needle biopsy



____Endoscopic biopsy



____Other (specify):_____________________________



_____Not specified


*Specimen Size



*Greatest dimension: __________cm



*Additional dimensions: __________ x __________ cm



*Cannot be determined


Tumor Site



Specify:_____________________________



____Not specified


*Tumor Size



*Greatest dimension: __________cm



*Additional dimensions: __________ x __________cm



*____Cannot be determined


GIST Subtype



____Spindle cell



____Epithelioid



____Mixed



____Other (specify):______________________________


Mitotic Rate



Specify:__________/50 high-power fields (HPF)


*Necrosis



*____Not identified



*____Present





*Extent: __________%



*____Cannot be determined


Histologic Grade



____GX: Grade cannot be assessed



____G1: Low grade; mitotic rate ≤ 5/50 HPF



____G2: High grade; mitotic rate > 5/50 HPF


Risk Assessment



____None



____Very low risk



____Low risk



____Intermediate risk



____High risk



____Overtly metastatic



____Cannot be determined


Distant Metastasis



____Cannot be assessed



____Distant metastasis





Specify site(s), if known:______________________________


Additional Pathologic Findings




Specify:______________________________


Ancillary Studies (select all that apply)



Immunohistochemical studies




____KIT (CD117)





____Positive





____Negative




____Others (specify):______________________________




____Not performed



Molecular genetic studies (e.g., KIT or PDGFRA mutational analysis)




____Submitted for analysis; results pending




____Performed, see separate report:______________________________




____Performed






Specify method(s) and results:______________________________




____Not performed


Pre-biopsy Treatment (select all that apply)



____No therapy



____Systemic therapy performed





Specify type:______________________________



____Therapy performed, type not specified



____Unknown


*Treatment Effect



*Specify percentage of viable tumor: __________%


* 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 Gastrointestinal Stromal Tumor.” Web posting date February 2010, www.cap.org.













































































































































































































































































































Gastrointestinal Stromal Tumor (GIST): Resection


Surgical Pathology Cancer Case Summary (Checklist)


Procedure



____Excisional biopsy



____Resection




Specify type (e.g., partial gastrectomy):______________________________



____Metastasectomy



____Other (specify):___________________________



____Not specified


Tumor Site



Specify (if known):___________________________



____Not specified


Tumor Size



Greatest dimension: _________cm



*Additional dimensions: __________ x __________cm



____Cannot be determined


Tumor Focality



____Unifocal



____Multifocal




Specify number of tumors:__________




Specify size of tumors:______________________________


GIST Subtype



____Spindle cell



____Epithelioid



____Mixed



____Other (specify):______________________________


Mitotic Rate



Specify: __________/50 HPF


*Necrosis



*____Not identified



*____Present






*Extent: __________%



*____Cannot be determined


Histologic Grade



____GX: Grade cannot be assessed



____G1: Low grade; mitotic rate ≤ 5/50 HPF



____G2: High grade; mitotic rate > 5/50 HPF


Risk Assessment



____None



____Very low risk



____Intermediate risk



____High risk



____Overtly malignant/metastatic



____Cannot be determined


Margins



____Cannot be assessed



____Negative for GIST





Distance of tumor from closest margin: __________cm



____Margin(s) positive for GIST





Specify margin(s):_____________________________


Pathologic Staging (pTNM)



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




____m (multiple)




____r (recurrent)




____y (post-treatment)



Primary tumor (pT)




____pTX: Primary tumor cannot be assessed




____pT0: No evidence for primary tumor




____pT1: Tumor ≤ 2 cm




____pT2: Tumor > 2 cm but ≤ 5 cm




____pT3: Tumor > 5 cm but ≤ 10 cm




____pT4: Tumor > 10 cm in greatest dimension



Regional lymph nodes (pN)




____Not applicable




____pM1: Distant metastasis






*Specify site(s) if known:______________________________


*Additional Pathologic Findings



*Specify:______________________________


Ancillary Studies (select all that apply)



Immunohistochemical studies



____KIT (CD117)





____Positive





____Negative



____Others (specify):______________________________



____Not performed



Molecular genetic studies (e.g., KIT or PDGFRA mutational analysis)




____Submitted for analysis; results pending




____Performed, see separate report:______________________________




____Performed






Specify method(s) and results:______________________________




____Not performed


Pre-resection Treatment (select all that apply)



____No therapy



____Previous biopsy or surgery




Specify:______________________________



____Systemic therapy performed




Specify type:______________________________



____Therapy performed, type not specified



____Unknown


*Treatment Effect



*Specify percentage of viable tumor: __________%


* 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 Gastrointestinal Stromal Tumor.” Web posting date February 2010, www.cap.org.

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Jul 9, 2016 | Posted by in PATHOLOGY & LABORATORY MEDICINE | Comments Off on Protocol for the Examination of Gist Specimens
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