Hepatocellular Carcinoma

Hepatocellular Carcinoma

*紅字為非必要項目

Hepatic Cancers Checklist
(含hepatocellular carcinoma及intrahepatic cholangiocarcinoma)

Hepatocellular carcinoma

Diagnosis

Gross Description:

  1. Procedure

Wedge resection/Atypical hepatectomy

Right lobectomy/Left lobectomy/segmentectomy

Total hepatectomy

Other (specify): ______

  1. Tumor Focality: Solitary/Multiple (number: )
  2. Tumor Site: Right lob/ Left lobe/ Caudate lobe / Quadrate lobe
  3. Tumor Size: x x cm
  4. Satellitosis: Not identified/ Present
  5. Large vessel involvement: Not identified/ Present
  6. Non-tumorous part: cirrhotic/ Not cirrhotic
  7. Gallbladder: size: x x cm.

Gallstone: Not identified/Present

Sections are taken and labeled as:

Microscopic Description:

  1. Diagnosis: Hepatocellular carcinoma

Fibrolamellar carcinoma

Other histologic type not listed (specify): ______Carcinoma, type cannot be determined

  1. Histologic Grade: (According to the Edmondson and Steiner System)

G1: Well differentiated

G2: Moderately differentiated

G3: Poorly differentiated

G4: Undifferentiated

  1. Tumor Extension

Tumor confined to liver

Tumor involves a major branch of the portal vein

Tumor involves hepatic vein(s)

Tumor involves (perforates) visceral peritoneum

Tumor directly invades gallbladder

Tumor directly invades diaphragm

Tumor directly invades other adjacent organs (specify):______

  1. Parenchymal Margin

Uninvolved by invasive carcinoma

Distance of invasive carcinoma from margin: cm

Involved by invasive carcinoma

  1. Vascular Invasion

Not identified

Present: Small vessel invasion/Large vessel invasion

  1. *Perineural Invasion: Not identified/Present
  2. *Regional Lymph Nodes

No lymph nodes submitted or found

Number of lymph nodes involved/examined: /

  1. Pathologic Stage Classification (pTNM, AJCC 8th Edition)

Primary Tumor (pT)

pT1:Solitary tumor <2 cm, or >2 cm without vascular invasion

pT1a:Solitary tumor ≤2 cm

pT1b:Solitary tumor >2 cm without vascular invasion

pT2:Solitary tumor >2 cm with vascular invasion, or multiple tumors, none >5 cm

pT3:Multiple tumors, at least one of which is >5 cm

pT4:Single tumor or multiple tumors of any size involving a major branch of the portal vein or hepatic vein, or tumor(s) with direct invasion of adjacent organs other than the gallbladder or with perforation of visceral peritoneum

Regional Lymph Nodes (pN)

pNX: Regional lymph nodes cannot be assessed

pN0: No regional lymph node metastasis

pN1: Regional lymph node metastasis

Distant Metastasis (pM) (required only if confirmed pathologically in this case)

pM1: Distant metastasis

Specify site(s): ______

  1. Additional Pathologic Findings

None identified

Low-grade dysplastic nodule

High-grade dysplastic nodule

Steatosis

Steatohepatitis

Chronic hepatitis (specify etiology): ______

Other (specify): ______

  1. Ishak modified staging of fibrosis

(0) No fibrosis

(1) Fibrous expansion of some portal areas, with or without short fibrous septa

(2) Fibrous expansion of most portal areas, with or without short fibrous septa

(3) Fibrous expansion of most portal areas with occasional portal to portal bridging

(4) Fibrous expansion of portal areas with marked bridging (portal to portal as well as portal to central

(5) Marked bridging with occasional nodules (incomplete cirrhosis)

(6) Cirrhosis (probable or definite)

  1. Gallbladder: No pathologic change/Chronic cholecystitis/Cholelethiasis
  2. *Ancillary Studies
  3. *Comment(s)

Intrahepatic cholangiocarcinoma

Diagnosis

Gross Description:

1.Procedure

Wedge resection/Atypical hepatectomy

Right lobectomy/Left lobectomy/segmentectomy

Total hepatectomy

Other (specify): ______

2.Tumor Focality: Solitary/Multiple (number: )

3.Tumor Site: Right lob/ Left lobe/ Caudate lobe / Quadrate lobe

4.Tumor Size: x x cm

5.Non-tumorous part: cirrhotic/ Not cirrhotic

6.Gallbladder: size: x x cm.

Gallstone: Not identified/Present

Sections are taken and labeled as:

Microscopic Description:

  1. Diagnosis:

Intrahepatic cholangiocarcinoma

Combined hepatocellular-cholangiocarcinoma

Intraductal papillary neoplasm with an associated invasive carcinoma

Mucinous cystic neoplasm with an associated invasive carcinoma

  1. Histologic Grade:
    G1: Well differentiated
    G2: Moderately differentiated
    G3: Poorly differentiated
  2. Tumor Growth Pattern
    Mass-formingPeriductal infiltrating
    Mixed mass-forming and periductal infiltrating
    Cannot be determined
  3. Tumor Extension
    Tumor confined to the intrahepatic bile ducts
    Tumor confined to hepatic parenchyma
    Tumor involves visceral peritoneal surface
    Tumor directly invades gallbladder
  4. Parenchymal Margin
    Uninvolved by invasive carcinoma
    Distance of invasive carcinoma from margin: cm
    Involved by invasive carcinoma
  5. Bile duct Margin
    Uninvolved by invasive carcinoma
    Involved by invasive carcinoma
  6. Lymphovascular Invasion: Not identified/Present
  7. Perineural Invasion: Not identified/Present
  8. *Regional Lymph Nodes
    No lymph nodes submitted or found
    Number of lymph nodes involved/examined: /
  9. Pathologic Stage Classification (pTNM, AJCC 8th Edition)
    Primary Tumor (pT)
    pTX:Primary tumor cannot be assessed
    pT0:No evidence of primary tumor
    pTis: Carcinoma in situ (intraductal tumor)
    pT1: Solitary tumor without vascular invasion, ≤5 cm or >5 cm
    pT1a: Solitary tumor ≤5 cm without vascular invasion
    pT1b: Solitary tumor >5 cm without vascular invasion
    pT2:Solitary tumor with intrahepatic vascular invasion, or multiple tumors, with or without vascular invasion
    pT3:Tumor perforating the visceral peritoneum
    pT4: Tumor involving local extrahepatic structures by direct invasion
    Regional Lymph Nodes (pN)
    pNX:Regional lymph nodes cannot be assessed
    pN0:No regional lymph node metastasis
    pN1:Regional lymph node metastasis present
    Distant Metastasis (pM) (required only if confirmed pathologically in this case)
    pM1:Distant metastasis
    Specify site(s), if known: ______
  10. Additional Pathologic Findings
    None identified
    Chronic hepatitis (specify etiology): ______
    Hepatolithiasis
    Other (specify): _____
  11. Gallbladder: No pathologic change/Chronic cholecystitis/Cholelethiasis
  12. *Ancillary Studies
  13. *Comment(s)