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- SM1 carcinoma penetrates the shallowest one-third of the
submucosa. - SM2 carcinoma penetrates into the intermediate one-
third of the submucosa. - SM3 carcinoma penetrates the deepest one-third of the
submucosa.
- Serial slices should be at 2–3 mm in thickness and embedded
on the same side to ensure equal intervals between sections,
and not less than 2 mm. They should be placed in the cassettes
with the side to be examined face down. The upward facing
surface should be dotted by ink to identify the correct surface
at embedding. No more than four pieces should be placed in a
cassette. An example of a typical block key for this kind of
specimen is given below:
Block Key:
1A Proximal section, en face.
1B–E Sequential transverse sections.
1F Distal section, en face. - A typical pathology report includes following features:
TISSUE LAYERS PRESENT: Mucosa/muscularis mucosa/
submucosa.
TYPE OF LESION: (e.g., adenocarcinoma, high grade
dysplasia/intraepithelial neoplasia).
HISTOLOGICAL TYPE: (e.g., signet ring cell, mucinous,
adenocarcinoma NOS).
HISTOLOGICAL GRADE:
PHENOTYPE:
TUMOR SIZE:
DEPTH OF INVASION: (e.g., T1a—tumour invades lamina
propria).
3-tiered (AJCC, 7th edition):
4-tiered (Stolte):
LYMPHATIC AND CAPILLARY SPACE INVASION:
Absent/Present.
PERINEURAL INVASION: Absent/Present.
SURGICAL MARGIN STATUS.
Deep margin: Not involved/Involved.
Distance to deep margin (if applicable).
Lateral margin (if applicable): Not involved/Involved.
Distance to lateral margin (if applicable).
OTHER PATHOLOGIES: (Barrett disease/scar formation/
ulceration/other).
Benjamin M. Allanson and M. Priyanthi Kumarasinghe