GI dataset

Question 1

Colorectal case - macro/specimen

Answer 1

Opening - if delayed, it should be kept in a fridge
Ink non peritonealised surface
Do not cut through tumour
Blocks - 5 tumour blocks
Invasion of veins
if less than 30mm should show relation to margin
Normal tissue
All LNs
Other abnormality

Question 2

Colorectal dataset

Answer 2

Nature + operation
Site of tumour, max dimension and distance to margin
Tumour perforation
Relation to peritoneal reflection
Plane of surgical resection
Distance to dentate line

Tumour type, grade
Stage
Tumour regression score
resection margin - if less than 1mm = involved
Lymph node tumoru deposits
Invasion - venous, lymph node, perineural
metastasis
MMR status

Question 3

Plane of resection CRC

Answer 3

Mesorectal - defect less than 5mm
Intramesorectal - cannot see MP
Muscularis propria - can see tear down to MP

For APE
Extralevator - en bloc resection including levator ani
Sphincteric - No levator ani
Intrasphincteric/submucosal - perforation

Question 4

Stage CRC TNM8

Answer 4

pT1 - submucosa
pT2 - muscularis propria
pT3 - subserosa, non peritonealised pericolic or perirectal tissue
pT4 - perforates peritoneum (a), invades adjacent organ (b)

N1a 1LN
N1b 2-3LNs
N1c tumour deposits
N2a 4-6LNs
N2b >7LNs

M1a 1 organ
M1b more than 1 organ
M1c Mets to peritoneum

Venous invasion
V1 - microscopic
V2 - macroscopic

L1 - lymphatic invasion

Pn1 - perineural invasion