Clinical Summary

Provisional diagnosis:

Specimen

Macroscopic

Specimen type:  			
Size of specimen:			
Size of tumour:			

Distance from bronchial 
margin:				
Distance from staple margin:	
Distance from nearest pleural 
margin:				

Separate nodules in 
same lobe:				

Background lung:			

Block codes:

Microscopic

Histological Type:			
If adenocarcinoma predominant
pattern:				
Other patterns:			
If adenocarcinoma maximum
size of invasive component:	

Grade:				For adenocarcinoma G1/G2/G3

Local Invasion:      
Vascular:				
Lymphatic:				
Visceral pleura:			PL0 / PL1 / PL2 / PL3
Spread through airspaces:		
Separate nodules in 
same lobe:				

Chest wall:				
Pericardium:				
Great vessels:			
Atrium:				

Margins:
Bronchial:				
Mediastinal:				
Staple:
Pleural:				
Chest Wall:				

Lymph Nodes (number involved / number examined)

Intrapulmonary nodes		
Number involved
/number submitted
Metastatic spread:			
Direct extension:			

Hilar nodes				
Number involved
/number submitted 
Metastatic spread:			
Direct extension:			

Part 2.
Station Number:			
Number involved
/number submitted:			

Part 3.
Station Number:			
Number involved
/number submitted:			

Part 4.
Station Number:			
Number involved
/number submitted:			

Part 5.
Station Number:			
Number involved
/number submitted:			

Part 6.
Station Number:			
Number involved
/number submitted:			

Part 7.
Station Number:			
Number involved
/number submitted:			

Other Pathology/Comments

Molecular testing:

SUMMARY
Tumour type:			
Pathological stage TNM 8:	
Adequacy of excision:		R0 / R1 / R2