Histopathology report

• type of procedure - wedge resection, lobectomy, bilobectomy, pneumonectomy.

• tumour type - squamous carcinoma/adenocarcinoma/small cell carcinoma/large cell carci-noma/neuroendocrine tumours/salivary gland type adenocarcinoma/others.

• tumour differentiation - well/moderate/poor.

• tumour edge - pushing/infiltrative.

• extent of local tumour spread. Elastin stain may be helpful in recognising visceral pleural invasion.

- pTx positive cytology but tumour not visualised by imaging or bronchoscopy.

- pTis carcinoma in situ.

- pT1 tumour < 3 cm diameter, surrounded by lung or visceral pleura and not invasive proximal to a lobar bronchus.

- pT2 tumour > 3 cm diameter or involves main bronchus 2 cm or more distal to the carina or invades visceral pleura. Partial atelectasis extending to the hilum but not involving the entire lung.

- pT3 tumour of any size that directly invades chest wall, diaphragm, mediastinal pleura or parietal pericardium or tumour of the main bronchus < 2 cm distal to the carina but without involvement of the carina or associated total atelectasis or obstructive pneumonitis of the entire lung.

- pT4 tumour of any size invading the mediastinum, heart, great vessels, trachea, oesoph agus, vertebral body or carina, or tumour with malignant pleural effusion or separate tumour nodule(s) in the same lobe.

- pM1 distant metastases, including separate tumour nodules in a different lobe (ipsilat-

eral or contralateral).

• lymphovascular invasion - present/not present

• regional nodes - intrathoracic, scalene, supraclavicular.

- pN0 no regional lymph node metastases.

- pN1 metastases in ipsilateral peribronchial/hilar/intrapulmonary nodes, including involvement by direct extension.

- pN2 metastases in ipsilateral mediastinal and/or subcarinal nodes.

- pN3 metastases in contralateral mediastinal, contralateral hilar, ipsi-/contralateral scalene or supraclavicular nodes.

At least 6 lymph nodes should be found in the hilar and mediastinal lymphadenectomy specimen. If less than this, and the lymph nodes obtained are negative, classify as pN0.

• excision margins - distances (mm) to the proximal bronchial, vascular and mediastinal limits and pleura.

• other pathology - atelectasis/bronchiectasis/lipid pneumonia/suppurative pneumonia.

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