HODGKIN LYMPHOMA: Biopsy, Resection

Andy Nguyen, M.D. / UT-Medical School at Houston, Pathology/ Last Revision on: 1/28/2013

Cancer Synoptic Case Summary

Specimen (select all that apply)

___ Lymph node(s)

___ Other (specify): ___________________________

___ Not specified

Procedure

___ Biopsy

___ Resection

___ Other (specify): ___________________________

___ Not specified

Tumor Site (select all that apply)

___ Lymph node(s), site not specified

___ Lymph node(s)

Specify site(s): ___________________________

___ Other tissue(s) or organ(s) (specify): ________________________

___ Not specified

Histologic Type (based on the 2008 WHO classification)

___ Hodgkin lymphoma, histologic subtype cannot be determined

___ Classical Hodgkin lymphoma, histologic subtype cannot be determined

___ Nodular lymphocyte predominant Hodgkin lymphoma

___ Nodular sclerosis classical Hodgkin lymphoma

___ Mixed cellularity classical Hodgkin lymphoma

___ Lymphocyte-rich classical Hodgkin lymphoma

___ Lymphocyte-depleted classical Hodgkin lymphoma

Pathologic Extent of Tumor (select all that apply)

___ Involvement of a single lymph node region

Specify site: _______________________________

___ Involvement of 2 or more lymph node regions on the same side of the diaphragm

Specify sites: _______________________________

___ Involvement of lymph node regions on both sides of the diaphragm

Specify sites: _______________________________

___ Spleen involvement

___ Liver involvement

___ Bone marrow involvement

___ Other site involvement

Specify site(s): _______________________________

Additional Pathologic Findings

Specify: _______________________________________

Immunophenotyping (Immunohistochemistry)

___ Performed, see separate report: ___________________

___ Performed

Specify method(s) and results: ______________________________

___ Not performed

Clinical Prognostic Factors and Indices (select all that apply)

___ International Prognostic Score (IPS) (specify): _____

___ B symptoms present