Non-Hodgkin Lymphoma/Lymphoid Neoplasms: Biopsy, Resection

Surgical Pathology Cancer Case Summary (Checklist)

Specimen (select all that apply)

____ Lymph node(s)

____ Other (specify): ______________________________

____ Not specified

Procedure

____ Biopsy

____ Resection

____ Other (specify): ______________________________

____ Not specified

Tumor Site (select all that apply)

____ Lymph node(s), site not specified

____ Lymph node(s)

Specify site(s): ______________________________

____ Other tissue(s) or organ(s): ______________________________

____ Not specified

Histologic Type

____ Histologic type cannot be assessed

Precursor lymphoid neoplasms

____ B lymphoblastic leukemia/lymphoma, not otherwise specified (NOS)^#

____ B lymphoblastic leukemia/lymphoma with t(9;22)(q34;q11.2); BCR-ABL1

____ B lymphoblastic leukemia/lymphoma with t(v;11q23); MLL rearranged

____ B lymphoblastic leukemia/lymphoma with t(12;21)(p13;q22); TEL-AML1 (ETV6-RUNX1)

____ B lymphoblastic leukemia/lymphoma with hyperdiploidy

____ B lymphoblastic leukemia/lymphoma with hypodiploidy (hypodiploid acute lymphoblastic leukemia/lymphoma [ALL])

____ B lymphoblastic leukemia/lymphoma with t(5;14)(q31;q32); IL3-IGH

____ B lymphoblastic leukemia/lymphoma with t(1;19)(q23;p13.3); E2A-PBX1 (TCF3-PBX1)

____ T lymphoblastic leukemia/lymphoma

Mature B-cell neoplasms

____ B-cell lymphoma, subtype cannot be determined (Note: Not a category within the WHO classification)

____ Chronic lymphocytic leukemia/small lymphocytic lymphoma

____ B-cell prolymphocytic leukemia

____ Splenic B-cell marginal zone lymphoma

____ Hairy cell leukemia

____ Splenic B-cell lymphoma/leukemia, unclassifiable^†

____ Splenic diffuse red pulp small B-cell lymphoma^†

____ Hairy cell leukemia-variant^†

____ Lymphoplasmacytic lymphoma

____ Gamma heavy chain disease

____ Alpha heavy chain disease

____ Plasma cell myeloma

____ Solitary plasmacytoma of bone

____ Extraosseous plasmacytoma

____ Extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma)

____ Nodal marginal zone lymphoma

____ Pediatric nodal marginal zone lymphoma^†

____ Follicular lymphoma