Cervix cancers

Carcinoma of the cervix click to access explanations in the original CAP template

This is additional protocol for excision specimen of cervix.

Microscopic descriptions:

- Tumor histology and immunohistochemical studies:

- Histologic type (WHO 5e):
- Histologic grade:
+ p16 immunohistochemistry:
- Depth of stromal invasion:	specify (mm):
- Depth of stromal invasion:	+ Extent of Depth of Stromal Invasion:
+ Horizontal extent of stromal invasion:
+ Silva pattern of invasion (endoCx adenoCA):
- Lymphatic and/or Vascular invasion:
+ Perineural invasion:

- Other tissue/ organ involvement: Not applicable Not identified Right parametrium Left parametrium Parametrium (side not specified) Vagina, upper two-thirds Vagina, lower one-third Vagina (location not specified) Right ovary Left ovary Ovary (side not specified) Right fallopian tube Left fallopian tube Fallopian tube (side not specified) Pelvic wall Bladder wall Bladder mucosa Rectal wall Bowel mucosa Omentum Other organs/tissue (specify): Cannot be determined (explain):

Surgical margins of excision specimen:

- Ectocervical margin: Cannot be assessed (explain): Uninvolved by invasive carcinoma, specify location and distance: Involved by invasive carcinoma, specify location: Uninvolved by intraepithelial neoplasia Involved by high-grade squamous intraepithelial lesion (CIN 2-3), specify location: Involved by adenocarcinoma in situ (AIS), specify location:

- Endocervical/lower uterine segment margin: Cannot be assessed (explain): Uninvolved by invasive carcinoma, specify location and distance: Involved by invasive carcinoma, specify location: Uninvolved by intraepithelial neoplasia Involved by high-grade squamous intraepithelial lesion (CIN 2-3), specify location: Involved by adenocarcinoma in situ (AIS), specify location:

- Vaginal cuff margin: Cannot be assessed (explain): Uninvolved by invasive carcinoma, specify location and distance: Involved by invasive carcinoma, specify location: Uninvolved by intraepithelial neoplasia Involved by high-grade squamous intraepithelial lesion (VAIN 2-3), specify location:

- Radial (circumferential) margin:

Pelvic lymph nodes (all):

- Number of lymph nodes examined:
- Number of lymph nodes with macrometastasis (>2 mm):
- Number of lymph nodes with micrometastasis (2-<0.2 mm, >200 cells):
- Number of lymph nodes with isolated tumor cells (<=0.2 mm, <=200 cells):
- Site(s) with positive lymph nodes:
- Size of largest metastatic deposit (mm), specify site:
- Size of largest lymph node involved (mm), specify site:
- Extranodal extension:

Pelvic sentinel lymph nodes:

- Number of lymph nodes examined:
- Number of lymph nodes with macrometastasis (>2 mm):
- Number of lymph nodes with micrometastasis (2-<0.2 mm, >200 cells):
- Number of lymph nodes with isolated tumor cells (<=0.2 mm, <=200 cells):
- Site(s) with positive lymph nodes:
- Size of largest metastatic deposit (mm), specify site:
- Size of largest lymph node involved (mm), specify site:
- Extranodal extension:

Para-aortic lymph nodes (all):

- Number of lymph nodes examined:
- Number of lymph nodes with macrometastasis (>2 mm):
- Number of lymph nodes with micrometastasis (2-<0.2 mm, >200 cells):
- Number of lymph nodes with isolated tumor cells (<=0.2 mm, <=200 cells):
- Site(s) with positive lymph nodes:
- Size of largest metastatic deposit (mm), specify site:
- Size of largest lymph node involved (mm), specify site:
- Extranodal extension:

Para-aortic sentinel lymph nodes:

- Number of lymph nodes examined:
- Number of lymph nodes with macrometastasis (>2 mm):
- Number of lymph nodes with micrometastasis (2-<0.2 mm, >200 cells):
- Number of lymph nodes with isolated tumor cells (<=0.2 mm, <=200 cells):
- Site(s) with positive lymph nodes:
- Size of largest metastatic deposit (mm), specify site:
- Size of largest lymph node involved (mm), specify site:
- Extranodal extension:

Distant Metastasis: Not applicable Not identified Uterine serosa: Adnexa: Inguinal lymph node(s): Omentum: Extrapelvic peritoneum: Lung (specify): Liver (specify): Bone (specify): Other (specify): Cannot be determined:

FIGO Stage (2018 FIGO Cancer Report):

I: Carcinoma is strictly confined to the cervix (extension to the uterine corpus should be disregarded)
- IA: Invasive cancer identified only microscopically. (All gross lesions even with superficial
invasion are stage IB cancers.) Invasion is limited to measured stromal invasion with a maximum depth
of 5 mm

-- IA1: Measured invasion of stroma less than 3 mm in depth
-- IA2: Measured invasion of stroma at least 3 mm but less than 5 mm in depth
- IB: Invasive carcinoma with measured deepest invasion of 5 mm or greater and limited to the cervix
uteri
-- IB1: Invasive carcinoma that is less than 2 cm in greatest dimension with a depth of invasion of
5 mm or greater
-- IB2: Invasive carcinoma with a greatest dimension of at least 2 cm but less than 4 cm
-- IB3: Invasive carcinoma 4 cm or greater in greatest dimension

II: The carcinoma extends beyond the uterus but has not extended onto the pelvic wall or to the
lower third of vagina

- IIA: Involvement of up to the upper two-thirds of the vagina. No obvious parametrial involvement
-- IIA1: Clinically visible lesion less than 4 cm
-- IIA2: Clinically visible lesion 4 cm or greater
- IIB: Obvious parametrial involvement but not onto the pelvic sidewall

III: The carcinoma involves the lower third of the vagina and/or extends to the pelvic wall and/or
causes hydronephrosis or nonfunctioning kidney and/or involves pelvic and/or para- aortic lymph nodes

- IIIA: Involvement of the lower third of the vagina but no extension onto pelvic sidewall
- IIIB: Extension onto the pelvic sidewall, and/or causing hydronephrosis/nonfunctioning kidney
(unless known to be due to another cause)
- IIIC: Involvement of pelvic and/or para- aortic lymph nodes, irrespective of tumor size and
extent
-- IIIC1: Pelvic lymph node metastasis only
-- IIIC2: Para- aortic lymph node metastasis

IV: Carcinoma has extended beyond the true pelvis or has involved (biopsy proven) the mucosa of
the bladder and/or rectum (bullous edema is not sufficient) or spread to distant organs

- IVA: Spread to adjacent pelvic organs, ie, tumor invading the mucosa of the bladder and/or
rectum (biopsy proven) and/or extending beyond the true pelvis (bullous edema is not sufficient)
- IVB: Spread to distant organs

+ Additional pathologic findings:

Low-grade squamous intraepithelial lesion (CIN 1) High-grade squamous intraepithelial lesion (CIN 2 or 3) Inflammation Endocervical adenocarcinoma in situ

- Other (specify):

- Additional notes: