Medical Pathology Report Form

Basic Report Information

Patient Name

Specimen Number

Age

Gender

Male Female

Ref By

Received Date

Date Reported

Nature of Specimen

Report Status

Clinical Data

Gross Description

Microscopic Description

Diagnosis

-MMR: The protein under study is considered intact (positive) if unequivocal nuclear staining of any intensity above background is seen in at least 90% of tumor cells. It is considered as lost (negative) if three is absence of any detectable nuclear staining or pale grey/tan staining in tumor cells. MMR is reported as showing heterogeneous staining if 10% or more of tumor area showing loss of expression of an MMR protein. - PD-L1: in gastric signet-ring cell carcinoma, PD-L1 positivity is assessed using the Combined Positive Score (CPS) and is considered positive when CPS ≥1, with CPS ≥10 representing high expression. - PD-1: PD-1expression is evaluated in tumour-infiltrating lymphocytes and is reported descriptively as absent, focal, moderate, or dense. - HER2/neu:HER2 immunohistochemistry is interpreted as negative when scored as 0 or 1+, defined by absent (0) or faint/barely perceptible membranous staining (1+) in tumour cells. A score of 2+ is considered equivocal, characterized by weak to moderate complete, basolateral, or lateral membranous staining, and requires reflex in situ hybridization for confirmation of HER2 gene amplification. A score of 3+ is considered positive, defined by strong complete, basolateral, or lateral membranous staining in tumour cells.

Referred paraffin block of gastric mass, endoscopic biopsy:<ul><li>MMR immunostaining: Heterogeneous expression due to focal loss of PMS2; MLH1, MSH2, and MSH6 intact.</li><li>PD-L1 positive (CPS = 25); PD-1 demonstrates moderate expression in tumour-infiltrating lymphocytes.</li><li>HER2/neu negative score 0</li></ul> COMMENT:<h5 class="ql-align-justify">The tumor demonstrates heterogeneous expression of PMS2, with intact MLH1, MSH2, and MSH6. This pattern suggests possible subclonal mismatch repair deficiency. While most tumor cells retain PMS2 expression, focal loss may have clinical significance. Recommend confirmatory testing for microsatellite instability (MSI) or molecular analysis to clarify MMR status, as heterogeneous staining can be associated with Lynch syndrome or influence immunotherapy eligibility.</h5><h5 class="ql-align-justify">High PD-L1 expression (CPS ≥10) has been associated with an increased likelihood of response to PD-1/PD-L1 immune checkpoint inhibitors in gastric and gastro-oesophageal adenocarcinoma in appropriate clinical settings. </h5>

Image Width (px)

Image Height (px)

Image Position

Template

المسافة الفارغة من أعلى الصفحة عند عدم استخدام قالب Header Space (mm)

Generate PDF