Small intestine cancers

Carcinoma of the small intestine click to access explanations in the original CAP template

Microscopic descriptions:

- Tumor histology and immunohistochemical studies:

- Histologic type (WHO 2019):
- Histologic grade:
- Tumor extension:
- Macroscopic Tumor Perforation:
- Lymphatic and/or Vascular invasion:
- Perineural invasion:
- Treatment effect:

* Please consider performing MMR/MSI and HER2 tests.

Surgical margins of segmental/ileocolic excision:

- Proximal margin:
- Distal margin:
- Radial or mesenteric margin:
- Other margin(s), specify :

Surgical margins of pancreaticoduodectomy:

- Proximal margin (gastric or duodenal):
- Distal margin (distal duodenal or jejunal):
- Uncinate (retroperitoneal/superior mesenteric artery) margin:
- Bile duct margin:
- Pancreatic neck/parenchymal margin:
- Other margin(s), specify :

Margin Status for Non-Invasive Tumor:

All margins negative for high-grade dysplasia and low-grade dysplasia
High-grade dysplasia present at margin	Proximal(specify): Distal (specify): Other (specify): Cannot be determined:
Low-grade dysplasia present at margin	Proximal(specify): Distal (specify): Other (specify): Cannot be determined:

Regional ymph nodes:

- Number of regional lymph nodes examined:
- Number of lymph nodes involved (specify locations):
- Extranodal extension:
- Size of largest metastatic deposit (mm), specify site:
- Size of largest lymph node involved (mm), specify site:

Distant Metastasis: Not applicable Not identified Non-regional lymph node(s) (specify): Liver (specify): Other (specify): Cannot be determined:

Pathologic Stage Classification (AJCC 8e):

- TNM Descriptors:	m (multiple primary tumors) r (recurrent) y (post treatment)
- Primary tumor (pT):
- Regional lymph nodes (pN):
- Distant metastasis (pM):

+ Additional pathologic findings:

Adenoma(s) Crohn disease Celiac disease Other polyps (type[s]):

- Other (specify):

- Additional notes: