Protocol for Thymoma and Thymic Carcinoma Specimen Examination



Protocol for Thymoma and Thymic Carcinoma Specimen Examination



















































































































































































































































































































































































































































Thymus: Resection


Surgical Pathology Cancer Case Summary (Checklist)


Specimen



____ Thymus



____ Thymus and other (specify): ______________________________



____ Not specified


Procedure



____ Thymectomy



____ Partial thymectomy



____ Other (specify): ______________________________



____ Not specified


Specimen Integrity



____ Intact



____ Disrupted



____ Indeterminate


Specimen Weight



Specify: __________ grams


Tumor Size



Greatest dimension: __________ cm




*Additional dimensions: __________ x __________ cm



____ Cannot be determined


Histologic Type



Thymoma (specify)




____ Type A thymoma




____ Type AB thymoma




____ Type B1 thymoma




____ Type B2 thymoma




____ Other (specify): ______________________________



Thymic carcinoma (specify)




____ Squamous cell carcinoma




____ Basaloid carcinoma




____ Mucoepidermoid carcinoma




____ Lymphoepithelioma-like carcinoma




____ Sarcomatoid carcinoma




____ Clear cell carcinoma




____ Adenocarcinoma




____ Well-differentiated neuroendocrine carcinoma, typical carcinoid




____ Well-differentiated neuroendocrine carcinoma, atypical carcinoid




____ Poorly differentiated neuroendocrine carcinoma, large cell neuroendocrine carcinoma




____ Poorly differentiated neuroendocrine carcinoma, small cell carcinoma, neuroendocrine type




____ Other (specify): ______________________________



____ Other (specify): ______________________________


Tumor Extension



____ Not applicable



____ Not identified



____ Cannot be assessed



____ Pulmonary parenchyma





*Specify lobe(s) of lung: ______________________________



____ Pleura





*Specify location: ______________________________



____ Pericardium



____ Diaphragm



____ Other (specify): ______________________________


Margins



____ Cannot be assessed



____ Margins uninvolved by tumor




Distance of tumor from closest margin: __________ mm



____ Margin(s) involved by tumor



Specify margin(s): ______________________________


Treatment Effect



____ Not applicable



____ Cannot be determined



____ Not identified



____ Present (specify: __________ % residual viable tumor)


Lymph-Vascular Invasion



____ Not identified



____ Present



____ Indeterminate


Regional Lymph Nodes



____ Cannot be assessed



____ No regional lymph node metastasis



____ Regional lymph node metastasis



____ No nodes submitted or found





Number of lymph nodes examined






Specify: __________





____ Number cannot be determined (explain): ______________________________





Number of lymph nodes involved






Specify: __________





____ Number cannot be determined (explain): ______________________________


Pathologic Staging for Thymomas (Modified Masaoka Stage) (applies only to thymomas)



____ Stage I: Grossly and microscopically encapsulated (includes microscopic invasion into, but not through, the capsule)



____ Stage IIa: Microscopic transcapsular invasion



____ Stage IIb: Macroscopic capsular invasion



____ Stage III: Macroscopic invasion of neighboring organs



____ Stage IVa: Pleural or pericardial dissemination



____ Stage IVb: Hematogenous or lymphatic dissemination



____ Cannot be determined


Implants/Distant Metastasis (select all that apply)



____ Cannot be assessed



____ Not identified





Specify site(s)





____ Pleura





____ Pericardium





____ Other (specify): ______________________________


Pathologic Staging for Thymic Carcinomas (pTNM) (does not apply to thymomas)



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




____ m (multiple primary tumors)




____ r (recurrent)




____ y (post-treatment)



Primary tumor (pT)




____ pTX: Primary tumor cannot be assessed




____ pT0: No evidence of primary tumor




____ pT1: Tumor completely encapsulated




____ pT2: Tumor invades pericapsular connective tissue




____ pT3: Tumor invades neighboring structures, such as pericardium, mediastinal pleura, thoracic wall, great vessels, and lung




____ pT4: Tumor with pleural or pericardial dissemination



Regional lymph nodes (pN)




____ pNX: Regional lymph nodes cannot be assessed




____ pN0: No regional lymph node metastases




____ pN1: Metastasis in anterior mediastinal lymph nodes




____ pN2: Metastasis in other intrathoracic lymph nodes, excluding anterior mediastinal lymph nodes




____ pN3: Metastasis in scalene &/or supraclavicular lymph nodes



Distant metastasis (pM)




____ Not applicable




____ pM1: Distant metastasis





*Specify site(s), if known: ______________________________



*Additional Pathologic Findings (select all that apply)



*____ Age-appropriate involution changes



*____ Fibrosis



*____ Cortical hyperplasia



*____ Cystic changes in tumor



*____ Cystic changes in adjacent thymus



*____ Other (specify): ______________________________


*Ancillary Studies



*____ Immunohistochemical staining



*Specify results: ______________________________


Protocol applies to thymic epithelial tumors located in any area of mediastinum.


*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 Thymoma and Thymic Carcinoma.” Web posting date: February 2011, www.cap.org.

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Jul 9, 2016 | Posted by in PATHOLOGY & LABORATORY MEDICINE | Comments Off on Protocol for Thymoma and Thymic Carcinoma Specimen Examination
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