LARYNX (SUPRAGLOTTIS, GLOTTIS, SUBGLOTTIS): INCISIONAL BIOPSY,
EXCISIONAL BIOPSY, RESECTION CASE SUMMARY
MNEUMONIC: LARYNX12
LARYNX (SUPRAGLOTTIS, GLOTTIS, SUBGLOTTIS): INCISIONAL BIOPSY,
EXCISIONAL BIOPSY, RESECTION CASE SUMMARY
SPECIMEN
Larynx, supraglottic
Larynx, glottis
Larynx, subglottis
Other (specify):
Not specified
RECEIVED
Fresh
In formalin
Other (specify):
PROCEDURE
Incisional biopsy
Excision biopsy
Resection
Endolaryngeal excision
Transoral laser excision (glottis)
Supraglottic laryngectomy
Supracricoid laryngectomy
Vertical hemilaryngectomy (specify side):
Partial laryngectomy (specify type):
Total laryngectomy
Neck (lymph node) dissection (specify):
Other (specify):
Not specified
SPECIMEN INTEGRITY
Intact
Fragmented
LARYNGECTOMY
Open
Unopened
SPECIMEN SIZE
Greatest dimensions: x x cm
Additional dimensions (if more than one part):
x
x
cm
TUMOR LATERALITY
Right
Left
Bilateral
Midline
Not specified
TUMOR SITE
Larynx, supraglottic
Epiglottis
Lingual aspect
Laryngeal aspect
Aryepiglottic folds
Arytenoid(s)
False vocal cord
Ventricle
Larynx, glottis
True vocal cord
Anterior commissure
Posterior commissure
Larynx, subglottis
Other (specify):
Not specified
Transglottic:
Yes
No
TUMOR FOCALITY
Single focus
Bilateral
Multifocal (specify):
TUMOR SIZE
Greatest dimension: cm
Additional dimensions: x cm
Cannot be determined (see comment)
TUMOR DESCRIPTION
Gross subtype:
Polypoid
Exophytic
Endophytic
Ulcerated
Sessile
Other (specify):
MACROSOCPIC EXTENT OF TUMOR
Specify:
HISTOLOGIC TYPE
Squamous cell carcinoma, conventional
Variants of Squamous Cell Carcinoma
Acantholytic squamous cell carcinoma
Adenosquamous carcinoma
Basaloid squamous cell carcinoma
Papillary squamous cell carcinoma
Spindle cell squamous cell carcinoma
Verrucous carcinoma
Giant cell carcinoma
Lymphoepithelial carcinoma (non-nasopharyngeal)
Neuroendocrine Carcinoma
Typical carcinoid tumor (well differentiated neuroendocrine carcinoma)
Atypical carcinoid tumor (moderately differentiated neuroendocrine carcinoma)
Small cell carcinoma, neuroendocrine type (poorly differentiated neuroendocrine
carcinoma)
Combined (or composite) small cell carcinoma, neuroendocrine type
Mucosal malignant melanoma
Carcinomas of Minor Salivary Glands
Adenoid cystic carcinoma
Mucoepidermoid carcinoma
Low grade
Intermediate grade
High grade
Other (specify):
Other carcinoma (specify):
Carcinoma, type cannot be determined
HISTOLOGIC GRADE
Not applicable
GX: Cannot be assessed
G1: Well differentiated
G2: Moderately differentiated
G3: Poorly differentiated
Other (specify):
MICROSCOPIC TUMOR EXTENSION
Specify:
MARGINS
Cannot be assessed
Margins uninvolved by invasive carcinoma
Distance from closest margin: mm or cm
Specify margin(s), per orientation, if possible:
Margins involved by invasive carcinoma
Specify margin(s), per orientation, if possible:
Margins uninvolved by carcinoma in situ (includes moderate and severe dysplasia)
Distance from closest margin: mm or cm
Specify margin(s), per orientation, if possible:
Margins involved by carcinoma in situ (includes moderate and severe dysplasia)
Distance from closest margin: mm or cm
Specify margin(s), per orientation, if possible:
Not applicable
TREATMENT EFFECT (APPLICABLE TO CARCINOMA TREATED WITH
NEOADJUVANT THERAPY)
Not identified
Present (specify):
Indeterminate
LYMPH-VASCULAR INVASION
Not identified
Present
Indeterminate
PERINEURAL INVASION
Not identified
Present
Indeterminate
LYMPH NODES, EXTRANODAL EXTENSION
Not identified
Present
Indeterminate
PATHOLOGIC STAGING (pTNM)
TNM Descriptors (required only if applicable)
m (multiple primary tumors)
r (recurrent)
y (post-treatment)
PRIMARY TUMOR (pT)
pTX: Cannot be assessed
pT0: No evidence of primary tumor
pTis: Carcinoma in situ
FOR ALL CARCINOMAS EXCLUDING MUCOSAL MALIGNANT MELANOMA
Primary Tumor (pT): Supraglottis
pT1: Tumor limited to one subsite of supraglottic with normal vocal cord mobility
pT2: Tumor invades mucosa of more than one adjacent subsite of supraglottis or glottis
or region outside the supraglottis (eg, mucosa of base of tongue, vallecula, medial
wall or pyriform sinus) without fixation of the larynx
pT3: Tumor limited to larynx with vocal cord fixation and/or invades any of the following:
postcricoid area, preepiglottic space, paraglottic space, and/or inner cortex of thyroid
cartilage
pT4a: Moderately advanced local disease. Tumor invades through the thyroid cartilage and/or
invades tissues beyond the larynx (eg, trachea, soft tissues of neck including deep
extrinsic muscle of tongue, strap muscles, thyroid, or esophagus)
pT4b: Very advanced local disease. Tumor invades prevertebral space, encases carotid artery,
or invades mediastinal structures
Primary Tumor (pT): Glottis
pT1: Tumor limited to the vocal cord(s) (may involve anterior or posterior commissure) with
normal mobility
pT1a: Tumor limited to one vocal cord
pT1b: Tumor involves both vocal cords
pT2: Tumor extends to supraglottic and/or subglottis and/or with impaired vocal cord
mobility
pT3: Tumor limited to the larynx with vocal cord fixation and/or invades paraglottic space
and/or minor thyroid cartilage erosion (eg, inner cortex)
pT4a: Moderately advanced local disease. Tumor invades through the outer cortex of the
thyroid cartilage and/or invades tissues beyond the larynx (eg, trachea, soft tissues of
neck including deep extrinsic muscle of the tongue strap muscles, thyroid, or
esophagus)
pT4b: Very advanced local disease. Tumor invades prevertebral space, encases carotid artery,
or invades mediastinal structures
Primary Tumor (pT): Subglottis
pT1: Tumor limited to subglottis
pT2: Tumor extends to vocal cord(s) with normal or impaired mobility
pT3: Tumor limited to larynx with vocal cord fixation
pT4a: Moderately advanced local disease. Tumor invades cricoid or thyroid cartilage and/or
invades tissues beyond the larynx (eg, trachea, soft tissues of neck including deep
extrinsic muscles of the tongue, strap muscles, thyroid, or esophagus)
pT4b: Very advanced local disease. Tumor invades prevertebral space, encases carotid artery,
or invades mediastinal structures
Regional Lymph Nodes (pN)
No nodes submitted or found
pNX: Cannot be assessed
pN0: No regional lymph node metastasis
pN1: Metastasis in a singe ipsilateral lymph node, 3 cm or less in greatest dimension
pN2: Metastasis in a single ipsilateral lymph node, more than 3 cm but nor more than 6 cm in
greatest dimension, or in multiple ipsilateral lymph nodes, none more than 6 cm in
greatest dimension, or in bilateral or contralateral lymph nodes, none more than 6 cm in
greatest dimension
pN2a: Metastasis in a single ipsilateral lymph node, more than 3 cm but not more than 6 cm in
greatest dimension
pN2c: Metastasis in multiple ipsilateral lymph nodes, none more than 6 cm in greatest
dimension
pN3: Metastasis in a lymph node more than 6 cm in greatest dimension
Specify: Number of lymph nodes examined:
Number cannot be determined (explain):
Number of lymph nodes involved:
Number cannot be determined (explain):
Lymph nodes:
Right cervical
Left cervical
Not applicable
#neg #pos <1 cm >1<3 cm >3<6 cm >6 cm node confined extranodal*
Level I ____ ____ _____ _______ _______ _____ _____________ ___________
Level II ____ ____ _____ _______ _______ _____ _____________ ___________
Level III ____ ____ _____ _______ _______ _____ _____________ ___________
Level IV ____ ____ _____ _______ _______ _____ _____________ ___________
Level V ____ ____ _____ _______ _______ _____ _____________ ___________
*if extranodal spread is present, specify micro or macroscopic
Lymph nodes:
Right cervical
Left cervical
Not applicable
#neg #pos <1 cm >1<3 cm >3<6 cm >6 cm node confined extranodal*
Level I ____ ____ _____ _______ _______ _____ _____________ ___________
Level II ____ ____ _____ _______ _______ _____ _____________ ___________
Level III ____ ____ _____ _______ _______ _____ _____________ ___________
Level IV ____ ____ _____ _______ _______ _____ _____________ ___________
Level V ____ ____ _____ _______ _______ _____ _____________ ___________
*if extranodal spread is present, specify micro or macroscopic
Distant Metastasis (pM)
Not applicable
pM1: Distant metastasis
Specify site(s), if known:
Source of pathologic metastatic specimen (specify)
FOR MUCOSAL MALIGNANT MELANOMA
Primary Tumor (pT)
pT3: Mucosal disease
pT4a: Moderately advanced disease. Tumor involving deep soft tissue, cartilage, bone, or
overlying skin
pT4b: Very advanced disease. Tumor involving brain, dura, skull base, lower cranial nerves
(IX, X, XI, XII), masticator space, carotid artery, prevertebral space or mediastinal
Structures
Regional Lymph Nodes (pN):
pNX: Regional lymph nodes cannot be assessed
pN0: No regional lymph node metastases
pN1: Regional lymph node metastases present
Distant Metastasis (pM)
Not applicable
pM1: Distant metastasis present
Specify site(s), if known
Source of pathologic metastatic specimen (specify):
ADDITIONAL PATHOLOGIC FINDINGS
None identified
Keratinizing dysplasia
Mild
Moderate
Severe (carcinoma in situ)
Non-keratinizing dysplasia
Mild
Moderate
Severe (carcinoma in situ)
Inflammation (specify type):
Squamous metaplasia
Epithelial hyperplasia
Colonization:
Fungal
Bacterial
Other (specify):
ANCILLARY STUDIES
Specify type(s):
Specify result(s):
Not performed
CLINICAL HISTORY
Neoadjuvant therapy
Yes (specify type):
No
Indeterminate
Other (specify):
Pathologic TNM (AJCC 7th Edition): pT N M