Melanoma

Malignant melanoma of the skin click to access explanations in the original CAP template

This is additional protocols for biopsy specimen and biomarkers.

Microscopic descriptions:

- Tumor histology and immunohistochemical studies:

- Histologic type (Melanoma in situ, anatomic level I):
- Histologic type:
- Maximum tumor (Breslow) thickness (to the nearest 0.1 mm):
+ Anatomic (Clark) level:
- Ulceration:
- Macrosatellite(s):
- Microsatellite(s):
- Mitotic rate:
- Lymphatic and / or Vascular Invasion:
- Neurotropism:
+ Tumor-infiltrating lymphocytes:
+ Tumor regression:

- Use 22 mm eyepiece at 40x objective, counting 42 active proliferative fields, approximating 10 mm², and reporting as number of mitosis per mm².

Surgical margins of excision specimen:

- Peripheral margins:
- Deep margin:
- Margin Involvement by Satellite(s):
- Margin Involvement by Tumor Regression:

Regional ymph nodes:

Please specify whether the LN metastasis is detected in H&E or in IHC.
Report involved LN in exact number or "at least ..."

- Number of sentinel lymph nodes examined:
- Number of sentinel lymph nodes involved:
- Number of regional lymph nodes examined:
- Number of lymph nodes involved (specify locations):
+ Nodal site(s) with tumor:
- Extranodal extension:
- Matted nodes:
- Size of largest metastatic deposit in sentinel LN:
- Size of largest lymph node involved in sentinel LN:
- Size of largest metastatic deposit in non-sentinel LN:
- Size of largest lymph node involved in non-sentinel LN:

Distant Metastasis: Not applicable Not identified Non-regional lymph node(s) (specify): Skin, subcutaneous tissues, soft tissues including muscle (specify): Lung (specify): Liver (specify): Other non-CNS sites (specify): CNS sites (specify): Cannot be determined:

Pathologic Stage Classification (AJCC 8e):

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

+ Additional pathologic findings:

Associated nevus (specify type):

- Other (specify):

- Additional notes: