Table 7. Structural report of colorectal endoscopic resection specimens*.
| Name Sex Age Pathology number Medical record number Inspection site | |
| *, For complete polyp or mucosal/intestinal wall excision specimens only. | |
| Specimen size | Maximum diameter: ____ cm; Other two diameters: ____ cm × ____ cm |
| Polyp size | Maximum diameter: ____ cm; Other two diameters: ____ cm × ____ cm |
| Polyp structure | □ Peduncle length ____ cm, diameter ____ cm □ Broad base |
| Type of polyp | □ Tubular adenoma □ Villous adenoma □ Tubulovillous adenoma □ Traditional serrated adenoma □ Sessile serrated lesions □ Hamartoma-like polyps □ Other |
| High-level intraepithelial neoplasia | □ None □ Yes □ Inherent membrane invasion (intramucosal carcinoma) |
| Invasive carcinoma (carcinoma infiltrating submucosa) |
□ None □ Yes |
| Size of invasive cancer | Maximum diameter: ____ cm Other two diameters: ____ cm × ____ cm |
| Histological classification | □ Adenocarcinoma, non-special type □ Serrated adenocarcinoma □ Adenoma-like adenocarcinoma □ Micropapillary carcinoma □ Mucinous adenocarcinoma □ Poorly cohesive carcinoma □ Signet ring cell carcinoma □ Medullary carcinoma □ Adenosquamous carcinoma □ Undifferentiated carcinoma, non-special type □ Carcinoma with sarcomatoid component |
| Histological grade | □ Uncertain □ Low level (well/moderately differentiated) □ High level (poorly differentiated, undifferentiated) |
| Tumor invasion (deepest point) |
□ Membrane propria □ Muscularis mucosae □ Submucosal layer (≤1,000 μm infiltration) □ Submucosal layer (>1,000 μm infiltration) □ Muscularis propria |
| Deep resection margin (pedunculated resection margin) |
□ Cannot be assessed □ Non-invasive cancer, invasive cancer distance from resection margin: ____ mm □ Invasive cancer involvement |
| Mucosal resection margin | □ Cannot be assessed □ No intradermal tumor and dysplasia □ Adenoma (low-grade intraepithelial neoplasia/dysplasia) visible □ High-grade intraepithelial neoplasia/dysplasia or intramucosal carcinoma □ Invasive cancer involvement |
| Tumor budding | □ Low (0−4/20 times if visual field) □ Medium (5−9/20 times of visual field) □ High (10 or more/20 times of visual field) □ Cannot be assessed |
| Vascular invasion | □ Invisible □ Microvascular invasion □ Lymphatic invasion □ Venous invasion □ Uncertain |
| Immunohistochemistry of mismatch repair protein | MLH1 ( ) PMS2 ( ) MSH2 ( ) MSH6 ( ) □ Not applicable |