Kidney pelvic and/or ureteric tumours
Macroscopic reporting dictation template
Data element
Fresh tissue received
Response
No
Yes
If yes, describe any additional tests/ frozen sections/biobanking performed
Procedure
Specimen integrity
Text
Intact
As stated by the clinician
Morcellated
If morcellated, record number of pieces of tissue received.
Specimen dimensions (entire specimen)
Specimen weight
Anatomical components and dimensions (as applicable)
Kidney
Ureter(s)
Adrenal
Gerota’s fascia
Other, specify
__x__x__mm
__ g
Number of tumours
For each tumour: (if >1 designate accordingly)
Tumour dimensions
Tumour site
__
Tumour description
Polypoid
Fungating
Tumour invasion (list all tissues invaded, more than one may
apply)
Distance of tumour to ureter cut margin
Distance of tumour to periureteric circumferential margin
Distance of tumour to perinephric fat margin
Lymph nodes
Other relevant macroscopic information
Describe nature and site of blocks
Periureteric tissue Renal parenchyma
Renal sinus
Other, specify
Perinephric fat
Gerota’s fascia
Adrenal
__mm
__mm
If applicable
__mm
If tumour has penetrated renal capsule
Not received
Received
Record number per cassette
Text
e.g. additional orientation etc
Text
Kidney pelvic and/or ureteric tumours dictation template
__x__x__mm
Length x max. diameter
__x__x__mm
__x__x__mm
Text
__x__x__mm
__x__x__mm
Renal pelvis
Date: 7 January 2016
__x__mm
Calyx
Upper
Mid
Lower
Papillary
Ulcerated
Max. wall thickness
__mm
Ureter
Pelviureteric junction
Solid & indurated
Scarring/fibrosis
Version: 1.2